Today was C-Day. "C" - for Caja, that is. The day we got down to the business of test-driving the Costa Rican national healthcare delivery system. We approached the day with more than a little trepidation.
We’d heard the horror stories about long waits to get an appointment (and sometimes getting turned away with getting one!), followed by long waits to see the doctor even with an appointment, followed by long waits to get prescriptions filled. We also had language concerns. How on earth would we ensure that we received the right care if we couldn’t communicate with our doctor?
That was then. This is now. And now we know we could have saved ourselves a lot of worry – thanks to the help of our Tico friend and a system that turned out to have a bigger bark than bite. Here’s how it went down.
2:45 a.m. – Forced ourselves out of bed. Drank a quick cup of coffee and downed a piece of breakfast bread. Dressed quickly. Met our friend at the gate at precisely 3:30 a.m.
3:35 a.m. – Took our place in line at the Caja clinic behind eight other souls who had awakened even earlier. Chatted between ourselves and gave thanks that we had our friend there to instruct us about where to stand and explain what was happening around us.
5:00 a.m. The rising sun provided enough light that I was able to read a few chapters of The Divinci Code while we waited.
5:40 a.m. Our friend’s father arrived and took his place in the Golden Citizens line ahead of us, nearer to the door. Because mi esposo is over sixty-five, we can do the same thing for our next appointment. This time around, even that advantage couldn’t pry us from the side our amigo.
6:00 a.m. The doors opened and the line began to move to the inside. One by one, each person stepped to a window, presented his/her Caja ID (carnet), orden patronal (a document that remains a mystery to me), and Costa Rican ID card (cedula). Once their paperwork was verified, they could chose an appointment time. Our friend proceeded to the window ahead of us and chose an 8:00 a.m. appointment. When it was our turn, we followed suit and received two tickets: one for our appointment and one for our pre-consultation (file-opening process).
6:20 a.m. Parted company with our friend. He returned home to get a shower and pick up his wife, for whom he had also made an appointment. (The way it works is that each person in line can make an appointment for him/herself and/or one other family member. Lucky her, she got to sleep in while her loving and generous husband waited in line!) We headed toward the bus stop to have breakfast at our favorite soda.
7:35 a.m. Arrived at Caja and sat down to wait for our friend and his wife to join us.
7:40 a.m. An English-speaking nurse approached us and asked if we had appointments. (Obviously, she very astutely assumed that we were unfamiliar with the process.) We answered in the affirmative, but she asked to see our tickets just to make sure. Then she told us that we should go ahead inside so they could prepare our files. Concerned that our friends would worry when they arrived and didn’t find us waiting, we called them and let them know that we were in the capable hands of a very helpful nurse who promised to help us every step of the way.
7:45 a.m. Entered an exam room where we were weighed, had our height recorded, and our blood pressure taken by one nurse, while another wrote the information on our new charts.
7:55 a.m. We were taken to a waiting area just outside an exam room labeled “Ebais Esquipulas,” where we waited less than two minutes before we heard our names called.
7:57 a.m. Entered a small office where a doctor was seated behind a desk. She answered with an emphatic “No,” when I asked if she spoke English. I showed her my husband’s records and started to explain as best I could that his doctor put him on a new medication right before we left and had instructed that he have a follow-up blood test when we were settled. She flipped through the papers and indicated that we should wait until she came back. I thought she had left to fetch our English-speaking nurse. Not.
8:02 a.m. Doctor returned and explained in Spanish that we would be seeing an English-speaking doctor. As usual, most of the words she spoke remained meaningless to us, but her picking up our charts and walking out the door with them, accompanied by a few hand gestures, effectively conveyed her intent. We waited where instructed until our names were called a second time.
8:05 a.m. Entered another exam room and were greeted by a very nice, young English-speaking doctor. Again, I presented our medical records and this time we were on our way. A few questions. A few answers. The old light in the ears, stethoscope to the chest, and then we got down to business.
Yes, he could provide prescriptions for most of our medications. They could be filled at the pharmacy upstairs. Mi esposo’s blood pressure prescriptions, however, were not on the formulary. We would have to continue filling them at a local pharmacy at our own expense.
Yes, he could write lab orders for all of the tests the private doctor had recommended. He added a couple more of his own.
8:30 a.m. Left the doctor’s exam room with a fistful of paperwork and proceeded to a clerk seated at a desk nearby. She asked us for our fathers’ and mothers’ names and our address in Esquipulas, adding the new information to the chart that had been initiated by the two nurses during our pre-consultation. Then she handed us our prescriptions, lab orders, receipts, and a paper indicating that we should return in one month.
8:35 a.m. Joined up with our friends and proceeded to the pharmacy, where a man seated at a window received our prescriptions, compared the names with our carnets, and instructed us to return in 90 minutes to pick them up.
10:00 a.m. Returned to pharmacy.
10:05 a.m. Picked up prescriptions and left.
For sure, the hardest part about the whole process was getting out of bed at 2:45 a.m. so that we could be in line as close to 3:30 as possible. Mind you, there was no requirement to do so. But when the clinic opens its doors in the morning, there are a finite number of appointment slots available, based on the number of doctors on duty that day. In our opinion, that little bit of extra sleep would have made for poor comfort if they turned us away before even reaching the appointment window when the slots filled up mid-way down the line.
If you're thinking that waiting in line for more than two hours is a real drudge, you'd be absolutely right. And waiting alone would be even worse. But then a little planning (like bringing a folding sling chair or small stool like one man did, as well as a book with one of those battery-operated book lights) would make a world of difference. As for us? The time passed quickly because we had each other to chat with – something I will try to remember when I am tempted to let mi esposo do the waiting while I catch a few extra ZZZZs at some point in the future.
In the end, our over-riding conclusions revolve around the courteous and helpful staff and the surprising efficiency of the process - not to mention the relief to find English-speaking staff! Granted, being able to pick up the phone and make an appointment would be a welcome improvement, but the arguments against streamlining the system are easily understood.
Any free healthcare system (make that free, aside from an affordable monthly premium that, in most cases is deducted from your paycheck) is ripe for over-use and abuse. Much of that risk has been reduced by simply inserting a degree of inconvenience into the process.
This way, folks who can afford to use a private doctor or clinic usually avoid Caja as much as possible, freeing up those resources for the people who need it the most. Then, when they are faced with an expensive procedure or long-term treatment, they too can crawl out of bed in the middle of the night and take their place in line in front of Caja. Or, they can opt for yet one more alternative. They can avail themselves of the services of a professional line-waiter. Yes, there is such a thing.
Costa Rica is a country with a strong entrepreneurial spirit. And for certain there are always people with more money than patience. This pairing goes a long way to explain why we weren’t the first ones in line at 3:30 in the morning. At least some of the eight people ahead of us had been paid the equivalent of a mere $5 USD to let someone else sleep a little later, enjoy a leisurely cup of fine Costa Rican coffee, and time their arrival at Caja for just before the doors opened at six. It’s a win/win proposition all the way around.
One final caveat: The information included here is based on our experience in the small town of Palmares, Alajuela. One thing we have learned is that generalization simply don’t work in Costa Rica (and perhaps nowhere else, for that matter). The same process might unfold quite differently in any other city or town, which is one more reason we are likely to make this our home for the foreseeable future.
Pura Vida
Tuesday, July 27, 2010
Friday, July 23, 2010
Right Place, Right Time
It's official. This past Thursday, we became card-carrying temporary residents of Costa Rica.
The process that brought us to this point took close to two years and involved documenting much of our lives in the U.S., paying legal and government fees, working with a Costa Rican attorney who navigated the sea of red tape, and a seemingly interminable wait for the finish line to come into view. So I found it fitting that the process should culminate with an abbreviated chorus of the same song - a little more paperwork, a few more fees, and a little more waiting all under the guidance of our attorney.
When it was over, a short 90 minutes after it began, we each walked out of migracion carrying our very own cedula, the Costa Rican national ID card.
One thing I have learned through this process is that each milestone ushers in a curious mix of elation, satisfaction, and poignancy. And so it was with this one - the biggest since this journey began.
For sure, we are thrilled to have completed the gauntlet. Having our new cedulas means that we no longer have to carry our passports every time we leave home (a personal "Wahoo!" for me, since I rarely have a really safe place to carry mine). It also means we can flash our cards to receive discount admission to national parks and other venues. And because mi esposo is over 65, we were issued "gold card" cedulas that entitle us to go to the front of the line at government agencies - a benefit worth its weight in gold at Caja clinics where waits can be unbearably long.
With it also came another one of those "pinch me" moments when you take a mental step back and try to bring the larger picture into focus. A moment when you say to yourself, "Holy cow! We really did it. We're immigrants living in a new country." A moment when you flip the coin back and forth, rub it between your fingers, and study both sides.
The side from your old life bears a comfortable familiarity and warm patina that is missing from the new side. And in those moments when you are truly honest with yourself, you have to admit that you miss it terribly. But the new side of this coin, impressed in a strange language and unfamiliar symbols, possesses the undeniable allure that comes when you know that you are exactly where you should be at this moment in time.
For us, Costa Rica is the place and this is the time.
Pura Vida
Wednesday, July 21, 2010
A Day of Ups, Downs, Ooops, Drats, & Whews
After smooth-sailing our way through our doctor's appointment this week, we set off with high expectations this morning on our way to have our blood work done. How naïve! And a real reminder that we have so much to learn.
We arrived at the laboratory at about 7:10 a.m. The sign on the door listed their business hours at 7:00 until 4:00, but the metal security shutters remained locked tight. After killing a little time walking around the block, we returned to find the office open for business.
A man in a white coat greeted us as we approached the counter and handed our doctor's order. In my most polite, friendly voice, I asked "¿Cuanto cuesta?". (In English: How much will this cost?) Without responding, he exited to the back office and held up his index finger when he returned, sans paperwork. A few minutes later a woman appears with a calculator, which she turned in our direction so that we could see the numbers. It read 86,650 colones.
We made a quick calculation, converting the amount to U.S. dollars (approximately $158 of them), thanked her and left. Gosh! Last year I had my well-woman exam done at Clinica Biblica in San Jose for a total of $380 and that included x-rays and the whole works! So our first reaction is that we had just encountered the gringo tax and not knowing what to do about that we approached the problem in true Tico spirit, deciding to deal with it manana. Well, maybe not tomorrow manana... but later, for sure. Tomorrow we have something much more important scheduled -- our immigration appointment.
As with all things Costa Rican, nothing is quite as simple as it might appear. Until yesterday, we believed that we had met every requirement and that all the pieces were in place for this all-important meeting. That was before a call from our attorney's office alerted us to the need to obtain my Caja carnet (national healthcare system ID card) - something we thought was only a priority if I actually wanted to use the system. Huh! More proof of our naïveté after two months on Costa Rica soil.
Here's how it works. We have qualified for temporary residency here solely due to the pensionado status of mi esposo. As far as migracion is concerned, I'm just along for the ride. Furthermore, a new immigration requirement stipulates that all residents, permanent and temporary, are required to join Caja. Hence, we assumed that as long mi esposo has met all of the requirement, e.g. he has a Caja carnet and proof that our premiums are paid up, that we were set for our appointment and could deal with my ID card ... well, whenever. (A little aside here to clarify that the premiums are $40 per month per family, so if he's paid up, I'm paid up.)
So, off we went to navigate the Caja maze once again. This time, though, we knew both our destination and the process since mi esposo had been down this road a few weeks ago.
The first step with any bureaucracy anywhere is to stand in line. It's the rule and has nothing to do with whether anyone is in line in front of you. Fortunately, we're getting quite good at it. And this time, we were in fact the first and only people in the line for the affiliation office at the Caja clinic. After about five minutes we were called into a small office where I proceeded to produce every piece of paper I believed to be required:
Passports (mine and that of mi esposo)
Marriage certificate
Comprobante de Cita, the document that declares that we have been granted temporary residency
Carnet for mi esposo
This was all good, but the nice young woman behind the desk wanted the document containing my Cost Rican social security number.
Oooops. I didn't have one - mainly because we didn't know I needed one!
And drats! This was a really big deal because to us it conjured up visions of us needing to hop on the next bus destined for the Caja office in San Jose.
Finally, whew! That fear was quickly squelched when we picked a few words out of the rapid-fire espanol explanation that indicated this could be obtained right here in Palmares.
Now all we had to do was to find the oficina de Seguro Social. She drew us a map that didn't make much sense to us, but we took it and headed out for the next leg of this marathon scavenger hunt.
We turned right because that's the direction she pointed. Three buildings down ... nothing. Hmmmm. Stopped to ask for directions. No entiendo. Walked a little further. Asked again. Received a personal escort down two blocks, turned right and there it was...a non-descript building with a small sign that read Seguro Social. Again a short wait, even though no one was in line in front of us. It's rule, remember. You always have to wait. But as short as these waits were, I'd be hard pressed to complain!
After more fumbling with papers and the tapping of computer keystrokes, I was handed a paper with a number highlighted in yellow marker. This was my new social security number.
Back at the afiliacion desk at the Caja clinic, we repeated the earlier steps, this time with all of the required documentation. We managed to understand questions like, father's name, mother's maiden name, our address... and then we were done.
On a scale of 1 to 10, I'd rank it somewhere in the 5 or 6 range. And to listen to some gringos who have gone through the process it could have been much, much more difficult, so we are feeling pretty good right now. This is not to say it was painless and without stress. Conducting business in a foreign country, without fluent language skills, and without the breadth of societal knowledge a person gains through osmosis during a lifetime of living in the country, will never be easy or comfortable. But it was manageable. At this stage of the game, we'll take it.
Pura Vida
We arrived at the laboratory at about 7:10 a.m. The sign on the door listed their business hours at 7:00 until 4:00, but the metal security shutters remained locked tight. After killing a little time walking around the block, we returned to find the office open for business.
A man in a white coat greeted us as we approached the counter and handed our doctor's order. In my most polite, friendly voice, I asked "¿Cuanto cuesta?". (In English: How much will this cost?) Without responding, he exited to the back office and held up his index finger when he returned, sans paperwork. A few minutes later a woman appears with a calculator, which she turned in our direction so that we could see the numbers. It read 86,650 colones.
We made a quick calculation, converting the amount to U.S. dollars (approximately $158 of them), thanked her and left. Gosh! Last year I had my well-woman exam done at Clinica Biblica in San Jose for a total of $380 and that included x-rays and the whole works! So our first reaction is that we had just encountered the gringo tax and not knowing what to do about that we approached the problem in true Tico spirit, deciding to deal with it manana. Well, maybe not tomorrow manana... but later, for sure. Tomorrow we have something much more important scheduled -- our immigration appointment.
As with all things Costa Rican, nothing is quite as simple as it might appear. Until yesterday, we believed that we had met every requirement and that all the pieces were in place for this all-important meeting. That was before a call from our attorney's office alerted us to the need to obtain my Caja carnet (national healthcare system ID card) - something we thought was only a priority if I actually wanted to use the system. Huh! More proof of our naïveté after two months on Costa Rica soil.
Here's how it works. We have qualified for temporary residency here solely due to the pensionado status of mi esposo. As far as migracion is concerned, I'm just along for the ride. Furthermore, a new immigration requirement stipulates that all residents, permanent and temporary, are required to join Caja. Hence, we assumed that as long mi esposo has met all of the requirement, e.g. he has a Caja carnet and proof that our premiums are paid up, that we were set for our appointment and could deal with my ID card ... well, whenever. (A little aside here to clarify that the premiums are $40 per month per family, so if he's paid up, I'm paid up.)
So, off we went to navigate the Caja maze once again. This time, though, we knew both our destination and the process since mi esposo had been down this road a few weeks ago.
The first step with any bureaucracy anywhere is to stand in line. It's the rule and has nothing to do with whether anyone is in line in front of you. Fortunately, we're getting quite good at it. And this time, we were in fact the first and only people in the line for the affiliation office at the Caja clinic. After about five minutes we were called into a small office where I proceeded to produce every piece of paper I believed to be required:
Passports (mine and that of mi esposo)
Marriage certificate
Comprobante de Cita, the document that declares that we have been granted temporary residency
Carnet for mi esposo
This was all good, but the nice young woman behind the desk wanted the document containing my Cost Rican social security number.
Oooops. I didn't have one - mainly because we didn't know I needed one!
And drats! This was a really big deal because to us it conjured up visions of us needing to hop on the next bus destined for the Caja office in San Jose.
Finally, whew! That fear was quickly squelched when we picked a few words out of the rapid-fire espanol explanation that indicated this could be obtained right here in Palmares.
Now all we had to do was to find the oficina de Seguro Social. She drew us a map that didn't make much sense to us, but we took it and headed out for the next leg of this marathon scavenger hunt.
We turned right because that's the direction she pointed. Three buildings down ... nothing. Hmmmm. Stopped to ask for directions. No entiendo. Walked a little further. Asked again. Received a personal escort down two blocks, turned right and there it was...a non-descript building with a small sign that read Seguro Social. Again a short wait, even though no one was in line in front of us. It's rule, remember. You always have to wait. But as short as these waits were, I'd be hard pressed to complain!
After more fumbling with papers and the tapping of computer keystrokes, I was handed a paper with a number highlighted in yellow marker. This was my new social security number.
Back at the afiliacion desk at the Caja clinic, we repeated the earlier steps, this time with all of the required documentation. We managed to understand questions like, father's name, mother's maiden name, our address... and then we were done.
On a scale of 1 to 10, I'd rank it somewhere in the 5 or 6 range. And to listen to some gringos who have gone through the process it could have been much, much more difficult, so we are feeling pretty good right now. This is not to say it was painless and without stress. Conducting business in a foreign country, without fluent language skills, and without the breadth of societal knowledge a person gains through osmosis during a lifetime of living in the country, will never be easy or comfortable. But it was manageable. At this stage of the game, we'll take it.
Pura Vida
Monday, July 19, 2010
Health Care the Costa Rica Way
We went to the doctor today. Now of course that's nothing new. In fact, it's something we do way more often that I'd like. But today was different. This was our initial consultation with our new primary care physician. And to understand just how different the medical system works in Costa Rica, one needs to start at the beginning of the story.
First, I have to point out that we are enrolled in Caja, Costa Rica's national healthcare system. So we could have chosen to go to our local clinic for free. That would have taken pretty much the entire day and would have required getting in line at 5:00 or 6:00 a.m. But many people, gringos and Ticos alike, choose to use a private doctor or clinic for routine matters and reserve the inconvenience of Caja for expensive treatments. Thus, our highly anticipated introductory visit with this particular, highly recommended doctor.
One of those recommendations had come over the kitchen table when we were visiting with one of our new English-speaking neighbors, who was born and raised in Palmares. The good doctor was a personal friend and was currently treating her gringo boyfriend, as a matter of fact. I mentioned that another Tico friend of ours had recommended the same doctor as well and that we planned to visit him soon. The next thing I knew, even though it was Saturday afternoon, we were soon talking with the doctor by telephone after a brief introduction from our neighbor.
When I explained that we simply needed some routine bloodwork done to monitor ongoing treatments, he offered to see us at his office at noon on Monday.
Okay... so that felt different. None of the usual checking of the schedule or talking to the scheduler or waiting for a week (or more). Simply, be there on Monday.
Well, as it turned out we arrived a wee bit early. Our plan was to allow ourselves extra time to locate his office (didn't want to be late, for goodness sake!) and then do a little shopping to kill time until our appointment. However, we found ourselves once again being escorted to our destination -- this time by a woman who insisted on staying with us until we made contact with the doctor. So much for that plan.
When we met the doctor we apologized for being early and tried to excuse ourselves util the appointed time. He would have none of it and insisted that we come in and get started right now. This was at 10:45 a.m. We left his office at 12:00 noon.
In the interim we chatted casually with him about how we came to be in Costa Rica, what our plans are, where he was from (Tanzania, though his grandparents were from India), how he came to be practicing medicine in Costa Rica (30 years ago and after practicing in the U.S. for a while) where we had visited while in the country (mostly the Central Valley and Quepos area), where he likes to go (San Carlos - and, by the way, would we like to go there with him some Sunday?), world affairs, politics (yes, we both like Obama), and how great life is in Costa Rica where things are not so frantic as they are in Norte Americana.
Eventually, we got around to medical histories, blood pressure taking and such (and, of course, the the writing of lab orders for the necessary test that had brought us to his office). And when we parted company more than an hour later, we felt confident that our new doctor understood not just the numbers and labels that define our medical conditions, but us -- that politics and current events are hot buttons (and stress triggers) for mi esposo and that I'm more of an it is what it is sort -- traits that readily demonstrate themselves in our blood pressure readings.
On the way out, he promised to call us sometime for that trip to San Carlos and told us to call him if we need anything ("You've got one more friend here now," he added.) Then we stopped at the front desk and paid our 40,000 colones ($80) for the doctor's time.
Oh yes, and about those blood tests... We'll have them done at the local laboratory tomorrow morning and pick up the results the same afternoon. Then we'll give the doctor a call to make an appointment for a follow up consultation -- for which there will be no additional charge.
How refreshing it is to see medicine practiced for the joy and satisfaction of helping people without the pressures imposed by "the system" on our doctors back home.
By the way... the Hypocratic Oath hung front and center on the wall behind his desk. It's been a while since I've seen that.
Pura Vida
First, I have to point out that we are enrolled in Caja, Costa Rica's national healthcare system. So we could have chosen to go to our local clinic for free. That would have taken pretty much the entire day and would have required getting in line at 5:00 or 6:00 a.m. But many people, gringos and Ticos alike, choose to use a private doctor or clinic for routine matters and reserve the inconvenience of Caja for expensive treatments. Thus, our highly anticipated introductory visit with this particular, highly recommended doctor.
One of those recommendations had come over the kitchen table when we were visiting with one of our new English-speaking neighbors, who was born and raised in Palmares. The good doctor was a personal friend and was currently treating her gringo boyfriend, as a matter of fact. I mentioned that another Tico friend of ours had recommended the same doctor as well and that we planned to visit him soon. The next thing I knew, even though it was Saturday afternoon, we were soon talking with the doctor by telephone after a brief introduction from our neighbor.
When I explained that we simply needed some routine bloodwork done to monitor ongoing treatments, he offered to see us at his office at noon on Monday.
Okay... so that felt different. None of the usual checking of the schedule or talking to the scheduler or waiting for a week (or more). Simply, be there on Monday.
Well, as it turned out we arrived a wee bit early. Our plan was to allow ourselves extra time to locate his office (didn't want to be late, for goodness sake!) and then do a little shopping to kill time until our appointment. However, we found ourselves once again being escorted to our destination -- this time by a woman who insisted on staying with us until we made contact with the doctor. So much for that plan.
When we met the doctor we apologized for being early and tried to excuse ourselves util the appointed time. He would have none of it and insisted that we come in and get started right now. This was at 10:45 a.m. We left his office at 12:00 noon.
In the interim we chatted casually with him about how we came to be in Costa Rica, what our plans are, where he was from (Tanzania, though his grandparents were from India), how he came to be practicing medicine in Costa Rica (30 years ago and after practicing in the U.S. for a while) where we had visited while in the country (mostly the Central Valley and Quepos area), where he likes to go (San Carlos - and, by the way, would we like to go there with him some Sunday?), world affairs, politics (yes, we both like Obama), and how great life is in Costa Rica where things are not so frantic as they are in Norte Americana.
Eventually, we got around to medical histories, blood pressure taking and such (and, of course, the the writing of lab orders for the necessary test that had brought us to his office). And when we parted company more than an hour later, we felt confident that our new doctor understood not just the numbers and labels that define our medical conditions, but us -- that politics and current events are hot buttons (and stress triggers) for mi esposo and that I'm more of an it is what it is sort -- traits that readily demonstrate themselves in our blood pressure readings.
On the way out, he promised to call us sometime for that trip to San Carlos and told us to call him if we need anything ("You've got one more friend here now," he added.) Then we stopped at the front desk and paid our 40,000 colones ($80) for the doctor's time.
Oh yes, and about those blood tests... We'll have them done at the local laboratory tomorrow morning and pick up the results the same afternoon. Then we'll give the doctor a call to make an appointment for a follow up consultation -- for which there will be no additional charge.
How refreshing it is to see medicine practiced for the joy and satisfaction of helping people without the pressures imposed by "the system" on our doctors back home.
By the way... the Hypocratic Oath hung front and center on the wall behind his desk. It's been a while since I've seen that.
Pura Vida
Sunday, July 18, 2010
Mosquitos 30; Me 2 -- But Things Are Trending in My Favor
It's probably too early to declare victory, but I just might be gaining on those pesky critters that like to munch on my feet, ankles, and arms during the night. In fact, Skintastic has earned it's place as my new best friend. (Sorry, Joan - but you're way up in Maine, leaving me to fend for myself down here.)
So far I've made it through two consecutive nights with no new bites by spritzing Skintastic on all of the exposed skin below my knees and on from my elbows to my wrists. Everything else is covered by jammies. if the results are any indication, I just might have gained the upper hand in this contest.
Wish me luck and an itch-free (& dengue fever & malaria-free) life here in mosquito paradise.
Pura Vida
So far I've made it through two consecutive nights with no new bites by spritzing Skintastic on all of the exposed skin below my knees and on from my elbows to my wrists. Everything else is covered by jammies. if the results are any indication, I just might have gained the upper hand in this contest.
Wish me luck and an itch-free (& dengue fever & malaria-free) life here in mosquito paradise.
Pura Vida
Thursday, July 15, 2010
Legal Odds & Ends - Getting a Costa Rica Drivers License: Day Two
It's done. As of this morning, we are licensed to drive in Costa Rica. Even better, the process turned out to be a lot simpler than we expected.
We boarded the Esquipulas to Palmares bus at 5:38 a.m., switched to the Palmares to San Jose bus less than five minutes before it pulled out, and exited at Hospital Mexico in Uruca about 45 minutes later.
Our instructions told us that the COSEVI building, where MOPT is located, would be right across from the Mercedes dealership - which was right across from the hospital. Well.... not quite. The road to the COSEVI building and the Mercedes dealership is right across the from hospital. The buildings themselves are actually about 3 km up that road - something we learned the way we learn most things in Costa Rica - by asking questions along the way and watching the body language that accompanies the response because we usually don't have a clue as to what the words are telling us.
When we arrived at MOPT at 7:45 we were directed to the last building in the back of the complex, where we found ourselves about 40 people back in the line that had probably started to form more than an hour earlier. The sky had been overcast and a brisk wind had been blowing all morning and right before the doors opened at 8:00 a light rain started to fall -- something that must happen often enough, because thankfully the entire walkway where the line formed was covered by a corrugated metal roof.
After a little more waiting, we were directed to the second floor where we produced our medical certificate from yesterday, our passports, and Arizona drivers licenses. Then our data was entered into a computer and we were given a slip of paper indicating that we each needed to pay 4,000 colones at the Banco de Costa Rica next door. A few minutes later we were back with our BCR receipt in hand and waited in another short line until we were called to have our photos taken and our index fingerprints recorded. At 9:30 we were handed our printed plastic Costa Rica drivers licenses.
My only complaint was that mine bears the worst picture I've ever taken, thanks to the damp breeze that turned my fine hair limp and straight ;( But if that's all I can complain about, given the horror stories we've heard about Tico bureaucracy, I can live with that small embarrassment.
Pura Vida
We boarded the Esquipulas to Palmares bus at 5:38 a.m., switched to the Palmares to San Jose bus less than five minutes before it pulled out, and exited at Hospital Mexico in Uruca about 45 minutes later.
Our instructions told us that the COSEVI building, where MOPT is located, would be right across from the Mercedes dealership - which was right across from the hospital. Well.... not quite. The road to the COSEVI building and the Mercedes dealership is right across the from hospital. The buildings themselves are actually about 3 km up that road - something we learned the way we learn most things in Costa Rica - by asking questions along the way and watching the body language that accompanies the response because we usually don't have a clue as to what the words are telling us.
When we arrived at MOPT at 7:45 we were directed to the last building in the back of the complex, where we found ourselves about 40 people back in the line that had probably started to form more than an hour earlier. The sky had been overcast and a brisk wind had been blowing all morning and right before the doors opened at 8:00 a light rain started to fall -- something that must happen often enough, because thankfully the entire walkway where the line formed was covered by a corrugated metal roof.
After a little more waiting, we were directed to the second floor where we produced our medical certificate from yesterday, our passports, and Arizona drivers licenses. Then our data was entered into a computer and we were given a slip of paper indicating that we each needed to pay 4,000 colones at the Banco de Costa Rica next door. A few minutes later we were back with our BCR receipt in hand and waited in another short line until we were called to have our photos taken and our index fingerprints recorded. At 9:30 we were handed our printed plastic Costa Rica drivers licenses.
My only complaint was that mine bears the worst picture I've ever taken, thanks to the damp breeze that turned my fine hair limp and straight ;( But if that's all I can complain about, given the horror stories we've heard about Tico bureaucracy, I can live with that small embarrassment.
Pura Vida
Wednesday, July 14, 2010
Legal Odds & Ends - Getting a Costa Rica Drivers License
This week we returned our attention to legal loose ends. It's one of those things that can soooo easily be left on the back burner since it usually entails hours of research to figure out where to go, what documents are needed, and last, but not least, how to get there.
But thanks to some perserverance, we are now one step away from having our Costa Rica drivers license. This is something we could have accomplished during our visit last year, but at that time we would have needed to hire someone to walk us through the process - a cost of around $200 for the two of us. Being frugal folks, we declined and chose to wait until we had the experience and skills necessary to go it alone.
I'm not sure we're really at that stage, but chose yesterday for the day because we needed to make a trip to San Ramon to pick up a package -- and because the 90-day deadline to use our U.S. driver's license to get one in Costa Rica without taking a written test was fast approaching.
Less than a half-hour after leaving our apartment we picked up our package and asked for directions to the MOPT office (9 blocks "that way") and we were off. We weren't really looking for MOPT at that point because we knew that the San Ramon office only issued renewals. For our initial license we will need to make a trip to the Uruca district of San Jose. But we had read that the clinics that provide the official medical exams required to obtain a drivers license line the streets near the MOPT office. So that's where we needed to go. (MOPT, by the way, is the equivalent of our Department of Motor Vehicles.)
We passed up the first clinic in favor of the next one, which looked a bit more welcoming and less third-worldly. Greeted by a woman with a stethoscope around her neck, we took seats at her desk and produced our passports. She entered our vital statistics onto two separate forms and walked us through a medical questionnaire, checked our vision by having us read a series of eight numbers from a chart across the room, asked us our typical blood pressure readings, collected 10,000 colones from each of us, signed the docs and we were on our way -- almost.
Before we could tick this one off our To Do List we needed to find out mi esponsa's blood type. (Mine [O neg] is indelibly etched into my brain, but not so for him, and our forms would not be official and complete without that tiny piece of information.) For this, the stethoscope lady sent us around the corner up the block and around the next corner to a laboratory.
Five minutes and 5,000 colones later we were finished and on our way in search of a new soda (Costa Rican coffee shop) for lunch.
Tomorrow, when we make a trip to San Jose to get our actual license, will not go as well... It's a given.
First, we have to set off at the crack of dawn -- well not actually dawn. Let's say before the fog lifts off the mountain in front of our apartment. In other words, by 6:00 a.m. The bus will surely be crowded at that hour, so hopefully we'll get on early and get a window seat, which is always my preference.
When we get off the bus the real fun will begin... as it always does when we cover new territory. This time, though, we'll hire a cab, which will save time, effort, and emotional energy.
We'll have to complete application forms - in Spanish, of course. Of course, we expect to wait in who knows how many lines, answer questions we don't understand, and in the end hopefully walk out with a little card with our photo on it... and the relief that comes with knowing that if we never let it expire, we'll also never have to take a written or behind-the-wheel driving test. That alone is enough motivation to get me up, dressed, and out the door by 6:00 in the morning -- with my dictionario in hand.
Pura Vida
But thanks to some perserverance, we are now one step away from having our Costa Rica drivers license. This is something we could have accomplished during our visit last year, but at that time we would have needed to hire someone to walk us through the process - a cost of around $200 for the two of us. Being frugal folks, we declined and chose to wait until we had the experience and skills necessary to go it alone.
I'm not sure we're really at that stage, but chose yesterday for the day because we needed to make a trip to San Ramon to pick up a package -- and because the 90-day deadline to use our U.S. driver's license to get one in Costa Rica without taking a written test was fast approaching.
Less than a half-hour after leaving our apartment we picked up our package and asked for directions to the MOPT office (9 blocks "that way") and we were off. We weren't really looking for MOPT at that point because we knew that the San Ramon office only issued renewals. For our initial license we will need to make a trip to the Uruca district of San Jose. But we had read that the clinics that provide the official medical exams required to obtain a drivers license line the streets near the MOPT office. So that's where we needed to go. (MOPT, by the way, is the equivalent of our Department of Motor Vehicles.)
We passed up the first clinic in favor of the next one, which looked a bit more welcoming and less third-worldly. Greeted by a woman with a stethoscope around her neck, we took seats at her desk and produced our passports. She entered our vital statistics onto two separate forms and walked us through a medical questionnaire, checked our vision by having us read a series of eight numbers from a chart across the room, asked us our typical blood pressure readings, collected 10,000 colones from each of us, signed the docs and we were on our way -- almost.
Before we could tick this one off our To Do List we needed to find out mi esponsa's blood type. (Mine [O neg] is indelibly etched into my brain, but not so for him, and our forms would not be official and complete without that tiny piece of information.) For this, the stethoscope lady sent us around the corner up the block and around the next corner to a laboratory.
Five minutes and 5,000 colones later we were finished and on our way in search of a new soda (Costa Rican coffee shop) for lunch.
Tomorrow, when we make a trip to San Jose to get our actual license, will not go as well... It's a given.
First, we have to set off at the crack of dawn -- well not actually dawn. Let's say before the fog lifts off the mountain in front of our apartment. In other words, by 6:00 a.m. The bus will surely be crowded at that hour, so hopefully we'll get on early and get a window seat, which is always my preference.
When we get off the bus the real fun will begin... as it always does when we cover new territory. This time, though, we'll hire a cab, which will save time, effort, and emotional energy.
We'll have to complete application forms - in Spanish, of course. Of course, we expect to wait in who knows how many lines, answer questions we don't understand, and in the end hopefully walk out with a little card with our photo on it... and the relief that comes with knowing that if we never let it expire, we'll also never have to take a written or behind-the-wheel driving test. That alone is enough motivation to get me up, dressed, and out the door by 6:00 in the morning -- with my dictionario in hand.
Pura Vida
Tuesday, July 6, 2010
"Welcome to Costa Rica!"
Today we took a trip to Alajuela to do some shopping. On the way back to the bus stop, I lost my sense of direction and was convinced mi esposa was leading us in the wrong direction. (Of course he turned out to be right, but that's another topic for another day.)
To settle our little dispute, we asked a woman at the intersection we were crossing for directions. She said something we didn't understand, but it seemed that we were supposed to follow her. So we did.
She led us to a little pulperia (corner grocery store) across the street and referred the question to a man inside, who turned out to be her husband. The next thing we knew we are being escorted by the entire family (husband, wife, & two sons - one about 8, the other about 11) the entire four blocks to the bus stop! When we got there the husband turned to us and said, "Welcome to Costa Rica!"
I'm sure this kind of thing might happen in other places. But it would be a rare experience where we come from and reminded us of one of the many reasons we love Costa Rica.
But that's not the end of the story...
Along the way, the older son, who was about the same height as his father, slung his arm over the man's shoulder walked the distance engrossed in happy chatter in a language we couldn't understand. Yet, while their words will forever remain a mystery, the affection and lack of pretense displayed in their body language was crystal clear.
What is even more amazing is that we have witnessed scenes like this one over and over again since arriving in Costa Rica. Public displays of affection are the rule here, not the exception. And they are not just limited to lovers in the park, although there are plenty of those, too!
Families flock to the parks on Sunday simply to spend time together.
Mothers and daughters walk arm in arm.
Sons hug their fathers.
The national greeting is a kiss on the cheek and a hug.
What else would you expect in a culture where the people have such a great love for life and each other?
Pura Vida
Thursday, July 1, 2010
Lawn & Garden Tools 101
Don't tell mi esposa, but he's getting a machete for Christmas. Really. You see, he loves to work in the yard and plans on planting a garden when we find a house to rent here. And from what we've seen, it may be the only tool he needs to do the job.
For sure, a Tico would laugh at the glutton of lawn and garden tools that fill our small tool shed at home. There are at least five different shovels, three rakes, a hoe, lopers, pruning sheers, hedge sheers, a tree trimmer and an assortment of hand shovels, hoes, etc. Phooey on that!
Day after day, we watch groundskeepers, homeowners, and even farmers tend to their properties with little more than the handy dandy, all-purpose machete. Apparently it is good for boring a hole in the soil to plan seeds, for tilling the soil between rows of plantings and for trimming bushes, hedgerows, and even trees. We've even seen it used to scalp the scrub grass from the dirt road below our balcony.
The other day our landlord hired a worker to trim a 100-foot row of border hedges that was easily five feet tall. The worker arrived with nothing but his machete and four hours later, the hedge was reduced to a cleanly-cut height of a little more than three feet. No gas. No battery. No power cord. Just a sharp knife and strong arm. Impressive!
In the same vein, we were talking the other day about needing to buy a lawnmower to bring along with us when we return in December. But I've been watching how they do things here and I'm thinking we might be able to forget that idea too. Things are more simple here and folks seem to have figured out that the trusty weed whacker mows down a yard full of grass just as easily as a bulky, maintenance happy power mower.
It does make one ponder how we let something as simple as lawn maintenance get so complicated. So Christmas just might have a few surprises for the man in my life. But I'm not expecting any surprises in return - like seeing him toss the shovels, rakes, and hoes into the garage sale pile. No more than me doing the same with my kitchen gadgets. Some changes will be much slower coming than learning to take the bus and shop at the feria.
Pura Vida
Christmas in July
We have wished many things for our children, but now we have a new one to add to the list: We wish them all the blessing of great friends.
Today we received a wonderful care package in the mail from the best friends a person could every hope to have. And look what was inside: chocolate, Vermont coffee, plastic containers, movies, music CDs, TUNA!, Scotch Brite!, and peppers (the specialty ones we can't get here!), tea towels, EARRINGS to make up for some of what I lost in the stolen bag and.... TP! (guess they were kind of grossed out when we told them we had switched to recycled TP). Thank you, guys! We love you and miss you.
Pura Vida
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