Ona Ysdira Choriuz Onchia, administrator of the new Cortes Hospital met with us to tell us about the history and present faculties of this very substantial and much needed addition to the Southern Zone, the new Cortes hospital. She was joined by two other assistant administrators, Jose Jerraldo Alvarez and Javier Barrantes Rosales. This very well thought out hospital is replacing the old hospital in the downtown area of the city of Cortez. How will it meet our needs?
The old hospital was founded in 1940 by a Dr. Thomas Cases Casajus and in his honor the new hospital also dedicated. Ysidira told us of her own rise to the level of Administrator by literally starting of the bottom. She has been in charge of practically every department, including the laundry. Javier told us of the very important role The American Fruit Company played in building the first hospital and how their influence still permeated the current design and construction of the hospital. They used to own most of the flat land around the southern zone, exporting much down the Terraba River. Since hurricane Mitch and the silt filling of the Terraba River the old hospital has experienced repeated flooding when it rains. Ysidira recounted an old lady in a wheelchair that they had to continually move around the hospital floor to get away from the water on the floor of the hospital. I asked Ysidra if there were crocodiles in the roads around the hospital when it flooded and she said there were. This alone would motivate me to move the hospital.
Not only was the hospital moved, so were the round spheres. There may have been more, but I counted two very large ones at the main entrance and one smaller one. We asked Javier which story about the spheres he believed was the true one. He said they were not from out space but were strategically placed by the indigenous peoples in various locations in this Southern Zone to line up with the stars, the sun and the moon in order to facilitate agriculture and issues of planting. They were brought to the hospital to remind everyone of their roots here in OSA.
Ysidra and Javier told us the architecture of the hospital with its many one story clinics was designed to minimize adverse impact on the environment and to protect against seismic activity. Again, they credited the American Fruit Company and their influence in terms of the verandas, the numerous windows to achieve maximum ventilation, maximum breeze and the feeling of open space. Javier commented several times o n the good things the American Fruit Company (AFC) did for the area and hospital.
The old hospital in old Cortes was funded by the AFC while this one was built by the InterAmericano Development……… or BVD. Total cost was C 3,993,7 million on a site of 11 hectares. It was built as a CCSS hospital for the entire area of Cortes, Palmar Sur y Norte, Rincon, Tinoco, Piedras Blancas, Sierpe, Ballena y Coronado.
In total there are 23 departments with 7 medical specialties. The hospital has 7 specialists, 10 general practice doctors and 30 nurses. While the old hospital had a nursing shortage this one is fully staffed. In comparison to the old hospital where “everything was mixed “, this hospital is clearly separated out into distinct areas. Women’s, gynecological and pediatrics are in one section but separate buildings, ER, kitchen, laundry, lab, x-ray, pharmacy, surgery, general medicine all boast their own quarters.
We asked who was entitled to use this hospital. It was made clear that the focus and energy of this facility was treating people and was not on garnering money. Anyone was entitled to use this hospital, including non-residents and visitors. All would be treated equally. We asked about payment, whether one needed money in their pocket at the time of admission and Ysidira said, “no way, that would not happen here.” She claimed that the priority here was treatment for those in need and payment for services would be determined by how much one could pay, and or by a search for organizations or agencies that could help make payments for those unable to pay.
Ysidira was clear to explain that each community had a free clinic or EBAIS which stood for Equipo Basico Attencion Integral de Salud. There is one in Coronado, Uvita, and Domincal. For normal issues, one should attend one of these clinics first, unless of course the problem was of an emergency nature. In that case, go straight to the hospital.
The first order of business would always be medical attention and that was the philosophy of this hospital. Ysidira mentioned three levels of treatment: first level was prevention, including house calls and caja seguridad (CCSS), the second was this rural hospital attending emergencies and third, if needed, transportation to San Jose to a specialist not in-house at the rural hospital. This could be accomplished by ambulance or even helicopter to Cima hospital in San Jose where there is a landing heliport. Is there one at Cortes? Yes, the school yard close by. In many cases the hospital psychologist might become involved in specific issues such as abuse of any kind. The hospital employs social workers as well who may be assigned to specific cases for home visits and management.
When asked about longeivity in Costa Rica and what was their opinion on those why Costa Rica could boast the longest average life span of anywhere in the world. All three pitched in to say that they felt the diet of rice, beans and vegetables without preservatives, chemicals, and microwaves was probably the reason. I added that the Costaricences generally don’t get mad or show anger. They agreed and added the tranquil nature of these people and their continual salud of “Pura Vida” possibly was a big factor.
We asked about specific illnesses and the statistics on those in Costa Rica. To my surprise they would give us no information on Sexually Transmitted Diseases saying the information was private. We were interested in numbers, not who. Ysidrira would only say that Herpes was a big issue on the street and AIDS exists. I would think these statistics would be information to be published to help deal with prostitution in Costa Rica and especially in this area, but no, this information was not forthcoming. I would hate think prostitution was viable government statistics feeding the coffers.
The most common issue treated at the hospital was road accidents and heart attacks. Javier cited the dreadfully dangerous bridge at Puenta Mala of having been a big source of road accidents. They cited falling asleep at the wheel as a big issue as well.
We asked about snake and spider bites. First, bypass the community clinic and proceed straight to the emergency room where they are well trained and equipped to handle these. The clinics do not have anti-venom.
Our final question was about food service, patient care and could the family be present at the hospital and in the patient’s room. Ysidira explained that each patient was interviewed as to their preferences and generally this was honored by the hospital. If the patient wanted home-cooking the family could bring food in and the patient could even be bathed and cared for by a family member. The philosophy was clearly one of “caring” for the patient. I heard more respect and dignity being potentially expressed toward a real healing of the patient than I have heard in any other hospital.
Many thanks to Ysidira, Javier and Jose