Week 2 – Clinica de Pavas

Hola! This week I had the privilege of working at my neighborhood’s health center (I live in Pavas, a residential section of San Jose). On Monday and Thursday, I worked in a primary care clinic with Dr. Chinchilla. Like most primary care physicians here, Dr. Chinchilla is a “generalist” – i.e. someone who has completed 5-6 years of medical school after high school + 1 “intern year” that is a mix of pediatrics, surgery, OBGYN, and general medicine. The clinic runs very much like one in the United States. There is a national electronic health record for writing notes and reviewing studies, but all lab and imaging orders and prescriptions must be printed out. Along with the many generalists at Clinica de Pavas, there are two pediatricians and one internal medicine physician for patients needing specialized care.

Clinica de Pavas is a “full-service” health center with an urgent care department, dentistry, psychology, nutrition counseling, social workers, x-ray and lab services, and a pharmacy in addition to the primary care providers I already mentioned. However, some patients are unable to come to the clinic because of age or mobility—so on Wednesday, I accompanied Dr. Chinchilla on his home visits around the neighborhood. We visited two patients with advanced dementia, a 95-year old woman with skin cancer, and a sharp-witted nursing home resident. 

I spent Tuesday with an ATAP (Asistente Técnico de Atencion Primaria, aka a Primary Care Technical Assistant) doing public health visits in a low-income neighborhood. ATAPs go door-to-door providing general health information and performing home assessments. They also offer vaccines and anti-parasitic medications. On Friday, I shadowed in the urgent care department, where each physician typically sees and manages 50 patients in an 8 hour-shift.

On my day off, I took a tour to Poas Volcano, the Doka Coffee Plantation, and La Paz Waterfall roughly an hour outside San Jose. Poas is an active volcano that last erupted in 2017, so you can only stay at the crater’s edge for 20 minutes (peep my awesome hard hat!). At Doka, I learned how coffee is harvested and processed – it is quite involved! The harvest season is typically November – January and seasonal workers can make up to $40 daily picking coffee beans, considered a good salary in Costa Rica.  Our tour ended with the La Paz Waterfall Nature Park, where they rehabilitate endangered animals among an exquisite jungle and waterfalls.

Now, looking forward to my coming week on the gynecology service at San Jose’s womens-only hospital!

Chao, Pura Vida!

– Allison

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