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Insufficient Healthcare Services Jeopardize Nosareños

Articles and Photos by Ashley Steyaert

The current state of affairs regarding public healthcare in Nosara and surrounding areas seems to have people on all ends of the spectrum disconcerted. The only government funded medical attention center, the EBAIS clinic in Nosara, is currently faced with double its attending capacity, leaving some 20-30 patients without receiving medical attention everyday. Private practitioners provide healthcare services to those who can afford it, but the absence of a local pharmacy has put them and their patients in a serious predicament regarding access to necessary medication.

The Red Cross is the only entity offering emergency transportation to the nearest hospital in Nicoya, but is faced with considerable underfunding, volunteer efforts, and community support. The above factors combined have resulted in a hazardous healthcare situation for Nosara area residents and visitors alike.

According to Nosara EBAIS General Practitioner Dr. Lisany Mejia Contreras, an approximated 50 patients arrive to her office daily soliciting medical attention. Dr. Mejia tells VON that the CCSS regulation states that one doctor can only give maximum of four medical consultations per hour, however, she sees an average of 7 patients an hour – nearly two times the legal regulation. She describes the current state of Nosara EBAIS personnel as “overloaded”, identifying the largest problem as “overpopulation”. When asked what would be needed in order to rectify the situation, Dr. Mejia replied that EBAIS Nosara needs “everything”, specifically mentioning “a second medical team” and the ability to handle “emergency situations”.

Dr. Lisany Mejia Contreras

María Estebana Hernández was also awating to see the doctor, and said that “we need another doctor, because Dr. Mejia works very hard and doesn’t even have time to eat lunch. She says, “Nosara isn’t like it used to be, we have a lot more people, so we need more doctors”.

Flora Chinchilla Mora

Assistant Medical Registration Technician, Flora Chinchilla Mora, has worked at the Nosara EBAIS Clinic for nearly three years. She tells VON that “we have too many patients, many people go without appointments [because] there isn’t enough space for them”. She says that the Nosara EBAIS “urgently needs another team so that we can attend to the patients that are left without appointments, some people wait here from 7:00am until 2:00 or 3:00pm” without seeing the doctor.

Among the numerous patients awaiting medical attention in the EBAIS Nosara waiting room was 28-year-old Fabiola Alvarez who says she “believe[s] the situation at EBAIS Nosara has been bad for years…the service is very slow [and that] more doctors are needed so that [receiving medical attention] would be faster”.

Private practitioner Dr. Kattia Porras Chacon provides general medicine attention to adults and children for a varying fee of around 24.000 colones a consultation. Dr. Chacon says that she is “not currently working with the [government instutions] CCSS or INS”, and therefore her patients must pay for their consultations themselves. In her opinion, although Nosara “currently has 3 private doctors, which [she] think[s] is more than enough for that which is private” medicine, and that “the Caja should currently have two attending doctors… it’s a problem [because] the population is very large.”

Dr. Alejandro Gutierrez, another of Nosara’s private doctors, think that the healthcare situation in Nosara “is a serious problem”. He says “in general I think that sometimes people don’t understand the reality of the EBAIS situation… it’s a first attention clinic, the purpose of EBAIS is to give first attention [for example] to children or patients with chronic illnesses… not to respond to emergencies… It’s complicated [because] we are far away from everything…The Red Cross is not the most efficient but they try to do what they can”, he adds.

President of the Nosara Red Cross Carlos Villalobos emphasizes that “the Red Cross is a private entity [which] gives assistances to EBAIS and other institutions in accordance with it’s capacities… “95% of those who work with us are volunteers who also work and/or study”. When questioned about recent deaths in the area which allegedly occurred as a result of not receiving medical attention in a timely manner, Villalobos replied “we feel that [those people] are the victims of an irresponsible community which charges the Red Cross with things that do not correspond to it. The government is to blame, [and] the people make no movement to have EBAIS open 24 hours.”

However, according to Acting Director of the Nicoya Area Health Diana Cortez Abarca, “the committee of Nosara has already made its petitions [regarding the current state of affairs in Nosara’s health care]”.

She tells VON that her office received the letters, and “they are climbing up” to higher authorities in the Regional Caja offices of Chorotega. She reports, “These are procedures which the regional levels are already doing, they have begun and it corresponds to them”. When asked when the people of Nosara might begin to see some changes in their local health services, Arbaca responded that “[she] can’t be precise” with that information.

It appears that all parties involved agree that there is a serious shortcoming in local healthcare, the effects of which are potentially very serious, especially to anyone who suffers from an injury or other emergency situation. Allegedly, the community has done what it can to obtain more sufficient government funded healthcare services in the area, and it is now up to the governmental entities to follow through with their obligations and provide what is needed.

Another patient was 19-year-old Alan Alvarez, who had already been waiting for nearly 6 hours. He declared, “I think the population here should have better [health] service”.



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