Apr 182009

We were in Costa Rica for three weeks, the first two on an Overseas Adventure Tour (OAT) with our good friends Naomi and Roger Murphy and 10 other people. We are publishing the third week first for the benefit of our fellow OAT travelers. (Hand written notes indicate sequence of accommodations over the OAT tour; San Jose and Santa Ana are near the “Airport” label – click to enlarge).

San Jose and Santa Ana

March 8 – The rest of the tour group has left the hotel by the time we go to breakfast. Now we are five. Eleanor made her own flight arrangements and is flying directly to Newark. She will be home in Scarsdale this afternoon. Roger and Naomi are going to visit an ATC (Affordable Travel Club) member in the mountains near Lake Arenal and then going to Monte Verde. We are off to our interview at Hospital Clinica Biblica and then to our ATC hosts in Santa Ana before venturing down south.

Alberto, the hotel van driver, drops the Murphys off at the Coca Cola bus terminal. We want to walk to the hospital, but Alberto tells us we would be in danger of losing our cameras and our wallets. He takes us to Clinica Biblica, the largest of three private hospitals in the San Jose area. It is a complex of historical and modern buildings that covers most of two blocks. Founded in 1921 as part of the Latin American Mission, it is now active in medical tourism, the subject of our interest.Brad Cook is the head of the International Department; Bill Cook, his brother, is the international patient coordinator. They attract patients from many countries – particularly the U.S. and Canada – for reduced-cost, high quality treatment. Early on, face-lifts were popular; now there is a wide variety of procedures including joint replacements and prostate treatment. Recently added is bariatric surgery, originally designed for weight loss, but found to result in lower blood sugar levels for Type 2 diabetics.

The hospital was the first in Costa Rica to win accreditation from Joint Commission International, which is associated with the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) that evaluates hospitals in the U.S. (Ruth coordinated JC surveys during her career in hospital administration.)

A network of medical tourism facilitators (akin to travel agents) in the U.S. arranges for patients to go to other countries for hospital treatment and recovery facilities. India, Thailand, and Mexico are other potential destinations, but Costa Rica boasts the best level of quality, falling one slot higher than the U.S. in the World Health Organization’s ranking of healthcare performance of their member countries.

Quality of care, proximity to the U.S., stable society and natural beauty of Costa Rica are advantages of Clinical Biblica touted by the Cook brothers. Both of the Cooks, sons of missionaries, were born in this hospital, raised in Costa Rica, attended college in the States and returned to Costa Rica. Both are married to Ticos (Costa Ricans) and speak mostly English with their children and Spanish with their wives. Bill, an amateur archeologist, spends his vacations on digs in Israel. Brad and his wife go to Houston where Argentine cousins have settled – his mother was from Argentina. “My wife,” Brad explains, “fits right in with their music and boisterous conversations.”

After a tour of the hospital, which is continually being upgraded with state-of-the-art medical equipment, inviting public food services and wi-fi connectability, we meet an American who is being discharged this Thursday afternoon.

Day before yesterday, Andrew L. had a hip replacement. His wife stays with him in his room (companions are encouraged). At night, an attendant makes up the futon into a full-sized bed for her.In 2001, Andrew had a major operation at Massachusetts General Hospital, removing and reconstructing half his pelvis. This surgery is a consequence of complications of that one. Although he and his wife now live in Costa Rica, they chose the medical tourism route for the transport and coordination services. His doctor is a “miracle worker” and the staff has “no complacency whatsoever,” says Andrew.

After two and a half hours at the hospital, we walk 10 blocks through the scuffy midtown past a photogenic church to Central Park near the National Theater and the Gran Hotel Costa Rica.

We sit on the hotel’s outside terrace, browsing copies of today’s New York Times and the Miami Herald. These are transmitted by some type of facsimile – perhaps e-mail – then reproduced and bound in tabloid size. Together they cost $17, a lot to pay anywhere but we are “international writers of medical tourism.” Then comes a good bottle of wine and the “surf and turf for two.”

Alberto said he would meet us in front of the theater at 4 o’clock. “Keep your straw hats on,” he said, “I won’t have trouble finding you.” He pulls up in front of us at 3:59 p.m.

Back at the La Condesa, we have two hours to spare before going to our ATC hosts. We had told them that we would arrive between six and eight o’clock (guests are encouraged to vacate premises during the day). We ask the Condesa reception clerk to call us a taxi and inquire what a fair fare should be. “Don’t worry, he works for us,” is the answer.

A little brown car (not the regulation red taxi) arrives with a strippling youth at the wheel and we embark on a wild ride around hesitating cars, through narrow alleys, over green hills and across wide valleys. Our driver takes many cell phone calls, some with a musical tone, others in Morse code: ditty dum dum ditty. Al, who hasn’t read code since leaving the Army Security Agency in 1955, recognizes SOS. Whoever that is seems to be in a lot of distress.

When we all realize we are lost, our driver refers once again to our hosts’ email directions in English and Spanish. He calls their number and gets further instructions. He needs to turn around with lines of cars rushing in both directions. Just as he’s about to poke into the oncoming lights, comes ditty dum dum ditty. He picks up the cell with his right hand and makes the turn by spinning the wheel with his left. Overshooting the address again by a block or so, he makes another high-traffic u-turn. Not until he stops at the heavy, polished wooden gate of the destination condo are we able to breathe normally.

Host Bill Vorih meets us at the door of his building and haggles with the driver over the fare, settlling at $30, saving us a few thousand colones (exchange rate is about 560 colones to the US dollar). We know Bill and his wife Cindy only from e-mails exchanged before we left home.We often quote an ATC member from Florida who says, “Tonight I am staying with friends I haven’t met yet.” Our new friends, the Vorihs, have been ATC members since 2004.
Started by a couple in Gig Harbor, Wash., ATC lists members throughout the world. We pay $60-70 a year depending on the directory format. A single guest donates $15 per night, $20 for couples. Some hosts add an additional $10 gratuity. Hosts provide a bed, breakfast and an hour of their time to explain their community, provide directions, and discuss other tidbits about the locale.

The Vorihs, who have lived in Costa Rica for 16 years, are very proud and appreciative of the country and the people. Their home, high in the hills, is in a complex that includes 16 condos. Theirs has 2700 square feet, three bedrooms, a large living room, three bathrooms and other rooms including an expansive kitchen. A second refrigerator houses a keg of Bill’s home-brewed beer and Cindy has two stoves for use in teaching a monthly cooking class for as many as 30 people.

Their hospitality starts at the door and continues over our two days at this end. We will return for our last day in Costa Rica. After a leisurely breakfast on Friday, Cindy points out the features in the view below, including a large business center and the airport in the distance.

The Vorihs offer to drop us at the shopping center on their way out to lunch with friends, saying that the narrow, deep ditched roads are not safe for us to walk.

The two-story covered shopping center is very chic, with elegant window displays in upscale shops – many with familiar names such as Guest and Nike.

Al gets a haircut and beard trim from a young woman who knows no English, but the man working next to her does. Al holds up two finders pointing to his head and three fingers to his beard and they understand that he means clipper blades. All goes well until she wants to trim his eyebrows. Al wants his to grow like Andy Rooney’s.

Next on the agenda is lunch. On the lower floor is a food court with representatives of most of the world’s fast-food purveyors. We are thinking Mongolian barbecue until we realize that all of the seats are taken. On the upper floor are sit-down places. We pick out one for fish and chips and wine. It is well situated for intense people-watching. Most of the people coming and going are young and well dressed.

One young woman walking with two young men has on a yellow vest and yellow shoes that demand Al’s camera. He asks her permission and she reluctantly agrees to a picture. But when Al returns to the table, he sees that the shoes are cut out of the picture. He runs down the mall, catching up to explain the need for a retake.

A regulation red taxi takes us back to the condo in a sedate, efficient style in sharp contrast to yesterday’s trip. After a good visit with our hosts, who arrange for an early morning taxi to take us on our next phase, Cyndy packs a brown bag breakfast for us.

We’re up at 3:30 a.m., tip-toeing around, but Bill is up to wish us well on our way.

Golfo Dulce

Our taxi is early and we arrive at the low white building some distance away from the international terminal with time to spare. The café isn’t open, but we have our bag breakfast. Eventually, we check in and are led to a flock of little white planes parked in rows on the tarmac. We crawl on-board, crabbing our way along the narrow, low-ceilinged aisle to one of the double seats on the right side. The left side has single seats contributing to the 12-passenger capacity.

Our co-pilot straps us into our seats with belts tight across our chests and laps. Two other passengers share our craft. The pilot guns the engine long and hard before starting up the runway. It feels shaky but we make it up over the mountain past the Vorih’s condo. We see water and a lot of forest without evidence of any human life. Less than an hour later the plane swoops down onto the Golfito airport. We are on the ground only minutes before another Sansa plane lands and ours takes off.We resist the cajoling of taxi drivers and, pulling our wheeled backpacks, start down to the road. Soon we realize we see no sign of the promised town and have no idea which direction to walk. A dusty red taxi comes along and we accept the ride. We stop first at the bank, on advice that this will be our last chance for an ATM in this area. Then, we ask the taxi driver to take us to Buenos Dias restaurant, which Lonely Planet says is a “cheerful spot”. And indeed, it is. The manager speaks passable English and the waitress tries hard. A couple of Gringo customers advise us that the manager will be happy to store our bags while we venture out.

We want to visit the Paradise Tropical Garden, which is near Rio Claro, a bus ride away. We explore just a little and find the dock where later we will get the water taxi to Zancudo. We learn that our bus travels south on the waterside of the only road and stops near the dock. Boarding the bus, we see no fare box, so we sit in one of several available seats. A “conductor” collects fares and attempts to help us figure out where to get off. He and many passengers – none of whom speak English – assist us in staying on the bus until the right stop, which is at the juncture of the Pan American Highway. Another red taxi driver knows where to take us, which is fortunate, because no signs appear to point the way.

At the entrance to the Paradise Tropical Garden, the legendary proprietor, Robert Beatham, meets us. He has not been back to Maine since 1985, yet he remains the quintessential independent “down Easterner.” Originally a maintenance engineer with United Fruit, he stayed after the company closed its Costa Rican operations. On a cruise, the woman who cut his hair later became his wife. Her death a few years ago has left a painful void in his life.

Robert takes us to a group of picnic tables, covered to protect from the sun. On one table is arranged a display of plants with descriptions of their medical properties. On this Saturday, about 30 kids and their teachers are exploring and waiting for explanations by Robert. His middle-aged son – one of four adopted sons – and the son’s wife are cooking a meal for the visitors in an outdoor kitchen. Robert leaves his young visitors to escort us around his garden. His first demonstration is to take off his straw hat and show us how he is treating a pre-cancerous sore with “black salve.” He tells us that in about two weeks the tumor, about the size of a thumbnail, will pop out and he will bath the spot with hydrogen peroxide.

We are most interested in Wandering Jew, as we have heard of its use to control blood sugar. Robert tells of a lodger in his wife’s boarding house, a salesman connected to the Duty Free zone, would put his insulin in her refrigerator. One trip, she found a bag of dark red leaves in place of the insulin. The salesman was putting a leaf in his morning tea or chewing a leaf three times a day to control his blood sugar.

We admire the large bush with burgundy colored leaves, which Robert tells us is Commelinaceae Tradescantia zebrina. He labels all the plants in Spanish, English and Latin. Back home, the owner of one of our favorite nurseries said she often carries Wandering Jew. ‘It is an old-fashioned house plant,” she said, “but it doesn’t thrive outdoors in this climate.”

Robert asks one of his helpers to harvest a coconut palm for us. Wielding a 15 foot to 20 foot pruning tool, he clips off one of the multifruited clusters and it drops to the ground at our feet. Then we start our tour with Robert’s brief descriptions of dozens of medicinal plants on the 50-hectare garden.Returning to the tables, we find the children and their teachers, finished with their meals, drawing, writing and playing games while waiting for Robert’s talk. He lets them wait a little longer while he drives us in his truck back to the junction. As we start to leave, a handsome little girl runs up to the truck to give him a message. He says she is five, was abused by her parents and taken away from them by government authorities. Now, at 85, he is planning to adopt her as his fifth child.

We ask a taxi driver about his fare to Golfito. Robert said it should be about 1000 colones; but this driver wants 10,000. No, gracias, we’ll wait for the bus. When it arrives just minutes later, we get our trip for 500 colones each.

The manager and waitress at Buenos Dias greet us like old friends. We order chicken salad for lunch while the manager calls the Los Cocos water taxi for us. Our trip to Zancudo was scheduled for 3 o’clock and it is just past noon. We can have a 1:30 p.m. pickup. “Look for the red Los Cocos boat,” we’re told.

At the muellecito (dock), a handsome young Tico with curly black hair starts talking to us. When we shy away, he says he is not about to scam us; he just wants to practice his English. He tells us he is caretaker at a home on a beach, reached only by boat. A young woman from the U.S. owns the place. Her grandfather left her with a monthly “pension” and her mother gave her the money to buy the home. “And I sleep with the owner,” our new friend says slyly.

Our Los Cocos captain, a young Robert, maneuvers through the anchored boats to the beach and helps us aboard. He zips the low outboard down the bay to a river surrounded by mangroves.

Zancudo is on a long narrow isthmus, with the Golfo Dulce on one side and rivers on the other. Traveling from Golfito by land requires a four-wheel drive vehicle and three hours time. By boat, it is a half hour and $60.

From the Zancudo dock, Robert leads us to a clearing, saying, “Susan will come.” Soon Susan does come in a four-passenger Toyota pickup. She is a handsome, well-tanned woman who first came to Costa Rica in 1977. She goes to the States only occasionally to visit her father in Boston and a sister in Utah. Yes, she knows OAT. She and her sister had taken their father on an OAT trip several years ago. “With the tour organized, we eliminated the power plays that make for bad situations,” she says.

Susan and her husband, Andrew, operate Los Cocos that includes a rental houses and cottages in additions to tours. They are next door to Sol Y Mar, where we have reservations. That open-air bar and restaurant is the community center for some 40 Gringo couples who live on Zancudo part of the year. Owners Rick and Lori also have a five cabinas, with rates $15 to $35 a night less than Los Cocos.The bar and restaurant strikes visitors as the perfect paradise business. In our brief experience the place is filled every afternoon and evening. They are open every day of the year, but Rick and Lori are there only in the high season from November to March. In the photo above, Karla is standing second from the left with Rick, seated, his back to us, without a shirt. She and Willie are the relief managers. Every spring, Lori, goes to Thailand to buy clothing that she and her sister sell at fairs in California during the summer. Their base is Chico, California where Rick studied forestry at the university. Before Thailand this year Rick and Lori are going to London and Ethiopia that they hope will be less crowded than Egypt last year. We walk on the beach, drink beers with shrimp cocktail snacks and, feeling the effects of our 3:30 a.m. wake-up call, go to bed.

The next morning, Sunday, Rick tells us about the regularly scheduled afternoon horseshoe tournament. We are there early with our cameras. It is like the NFL – the players take turns warming up. The contest goes on far into the evening with the well-lighted pits.

Monday morning, per arrangement, Susan comes to take us kayaking. The tide is ebbing, making the dock ramp down to the water steep. After Al and Ruth struggle to get one kayak in the water, an angler comes by, picks up the remaining kayak and walks it down the dock. These are single sit-on-tops. We’re used to a double ocean kayak where we sit in a cockpit and we can spell each other off during long stretches. We also miss life vests and mooring ropes, but, it was a nice day, paddling is our favorite sport, and Susan is charging us only $5 an hour. With a laminated map, she explains a route – out around a sand bar and into the river where we will see abundant birds and maybe monkeys.

The short of it is we don’t get around the bar. Al finds he is stuck and the tide is still running out. (This is not the first time. See Ruth’s article, “A Day in the Mud,” at www.prudentventures.com) “Sand bar” sounds nice, like on the beach. This is a MUD bar. Ruth has no rope to throw to tow Al off. He realizes he is firmly stuck and his best hope is get out of the kayak and push off, but his feet get stuck and he recognizes that his new water sandals are being sucked off and these are the only shoes he brought, so he tries not putting weight on his feet, which helps a little but he is running out of energy until he leans on the edge of the kayak, making it a little easier for his feet to come free without losing the sandals; finally he pushes the kayak into deeper water and with a burst of new energy is able to slither back into the kayak.

By the time we make it to the dock Andrew, Susan’s husband, is there. He helps us to his truck. We are relieved to be in his hands. He tells us he and a Los Cocos tour group passed in their boat and watched us laboring. He asks, “Did you know there was a crocodile between you and the shore?’ Wonderful!

In the bar at Sol Y Mar, Andrew is a joker, but on Zancudo’s only road he calls out or hits his horn for everyone we pass. Most wave or call back. One girl, running across the road and into her property doesn’t look back, but does a dance, waving her hands above her head.

Andrew says he knows Robert Beatham. “Is he a seer or a nut?” we ask. Andrew says that Robert is a “serious person” who knows a great deal about plant cures. “But,” he explains,”now only older people are interested in what Bob knows. With government funded health care, it is easier to go to the hospital pharmacy and get pills.”

As non-citizens Andrew and Susan are ineligible in the government health plan; they pay $1,500 a year for private coverage and get their care at Clinica Biblica. Andrew tells us how, when he blew out his back, he was flown to San Jose and the hospital on a stretcher. Soon, he said, he was back home whole, and his private plan covered everything, including transportation.

Andrew delivers us to Sol y Mar, where we find only a trickle of water in the shower, so we de-mud at the outdoor faucet. Electric power is out, affecting the pump and all other electrical equipment. The staff struggles to find something for lunch.

We walk the shaded path over to Los Cocos to ask Susan about a tour of the Osa Peninsula, said to be the most beautiful and unspoiled jungle in Costa Rica and home to the most renowned (and expensive) eco resorts. She schedules Robert to take us in the boat to Puerto Jimenez, where we will meet a taxi driver who will show us around.

“Does he speak English?” we ask. “No, if he spoke English, he wouldn’t be a taxi driver, he’d be a guide and earn more,” Susan says. As it is, we are spending $60 for the boat trip each way and $80 for four hours in the taxi.
Dennis, the taxi driver, waits at the dock to help us off the boat. He has a shining red four-wheel-drive Toyota. First, in perfectly acceptable English, he gives us a tour of the dusty town, the gateway to the Osa, with a paved airstrip in addition to the dock. He points out a few simple hotels and restaurants.

But what he’s proudest of is a flock of scarlet macaws. One perches at the top of a tree in the sun to provide the best picture of our three weeks in Costa Rica. On the way out of town, he stops to show us a family of monkeys.

The road through the jungle is bumpy. A Gringo woman on a motor bike stops to share a few words with Dennis. She is Nico Fischer from our first eco-resort, Ojo del Mar, and author of “Living in the Jungle – A Handbook for Sustainable Living on the Osa Peninsula, in the Golfo Dulce Area and for Anywhere Else you Care.”

Ojo del Mar is a small lodge, featuring the beautiful woods of Costa Rica. A young woman meets us and offers a cup of good Costa Rican coffee. Emily Carson is from Vermont where she went to college and worked at a coffee shop whose proprietor knows the Ojo owners. She tells us that Mark Heubner, the German co-owner, designed and built the “main house” without use of power tools.

Touring the lush grounds, we ask about the yoga platform. She says she doesn’t know much about the yoga because she is cooking breakfast at that time.

Ojo del Mar is certified in the nation’s sustainability program. Solar power provides electricity in the main house.

Standard rooms are $55 to $90 per night including breakfasts. Dinners are available for less that $20. Meals are communal and offer organic produce, mostly vegetarian, but some chicken and local fish are available.

As we continue on our tour, the road gets rougher. Several times, we forge streams with no bridges. There are 14 such river crossings, which can be difficult to impossible in the wet season, Dennis tells us.

Our second stop is at Encanta La Vita (Enchanted Life), developed by a surfer from Santa Barbara. Brian Dailey tells us he built this beautiful house first for himself, then other buildings and soon he had a lodge, and his enchanted life. He is proudest of the pool. This resort isn’t listed in The Lonely Planet nor in the country’s sustainability program (www.turismo-sostenible.co.cr/).

However, Brian says, “We value the wonders of the jungle and the Costa Rican culture. That’s why we’re here.” Rates per person per night range from $85 to $175, including three meals a day.

Our third stop is at Lapa Rios, the most renowned ecolodge in the area, which has earned five Certified Sustainability levels. Sixteen “spacious” thatched bungalows dot the 400-hectare “reserve.” The rate for a single, including all meals, is $350 in Green (wet) season and $460 in High (dry) season. Karen and John Lewis from Minneapolis built Lapa Rios, and have signed the property over to the Nature Conservancy for preservation. Here, as at the other lodges, Dennis is greeted as a friend more than just a driver who transports customers to them. The front desk receptionist, Eusebio Martinez, takes Ruth on a tour that starts with a climb up the spiral staircase to a platform overlooking the treetops to the beach and water and ends at the fresh salt-water pool.

That evening back at Sol Y Mar, regulars at the bar ask us how we enjoyed the afternoon on Osa – information travels fast in Zancudo.

The next day, our last, we take a long walk on the beach, celebrating that we are going to another beach where the waves are just as beautiful. We peer through the trees to look at houses. Most are simple; however, we find one palace that looks like a page from Architectural Digest. As we’re packing to leave, our cabin shakes. We know EARTH QUAKE! At the restaurant, the TV is tuned to a news broadcast reporting the six plus temblor was centered in the middle of Golfo Dulce.

The boat trip back to Golfito and the plane ride – six passengers this time – to San Jose are uneventful. The Murphys greet us at the Vorihs’ condo. We hug as if we had been away six months.

The Vorihs invite us to share their “boca” (cocktail party), welcoming friends from the States. A blazing sunset floods through the wall of windows as we say farewell to our Costa Rican adventure.

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