San José, Costa Rica, since 1956

Dengue, Infrastructure Topped Health Concerns

As occurs every year, the year in health in Costa Rica was defined by infrastructure, or lack thereof, with a two-year-old news event persisting in symbolizing the deficits of the country’s public health system.
The aftermath continued of the tragic July 2005 fire that killed 19 people (16 patients and three nurses) at San José’s Calderón Guardia Hospital. At mid-year, a former hospital worker was convicted of arson in the incident and sentenced to 50 years in prison, and the public Social Security System (Caja) began negotiating out-of-court settlements with victims’ families.
Yet a Tico Times investigation showed that much remains to be done to bring the country’s 29 public hospitals up to fire-safety codes, with Caja officials admitting that it could take 20 years and $160 million for the goal to be fully realized.
Calderón Guardia itself beefed up security with a $1 million program that includes auxiliary water pumps, backup lighting and training of staff on evacuation procedures, none of which was in place that fateful night.
International politics took their toll on the hospital situation, with $15 million in aid from Taiwan, earmarked for post-fire reconstruction, evaporating when President Oscar Arias broke diplomatic relations with that country in favor of ties with China (see separate story.) The Arias administration assured the public that reconstruction would continue on the two floors of the hospital gutted in the blaze.
The Caja received good news this year too. The cash-strapped institution received an early holiday gift from the government: the announcement that it would cancel its ¢185 billion ($358 million) debt, a situation that will allow the public-health system to invest in infrastructure.
Officials also announced that construction would begin on an $85 million hospital in the northern Central Valley city of Heredia, which will replace the city’s aged, existing facility, and should open in 2009.
Costa Ricans go outside the public system to spend big colones on private health care, it was revealed this year, to the tune of $157 million during a four-month study period.
International visitors also know the parallel private system too, with the Costa Rican Tourism Institute (ICT) estimating that at least 1% of all tourists come here for medical reasons. The Clínica Bíblica Hospital in San José established an international outreach office early in 2007, with an entire floor dedicated medical tourism.
June’s Taiwan-to-China diplomatic changeover also came at a time of growing awareness of potential health hazards associated with products from the mainland. Like much of the world, Costa Rica found itself recalling possibly toxic Chinese toothpaste, and Chinese-made toys painted with unacceptably high levels of lead.
Dengue remained Costa Rica’s most worrisome public-health problem, with case numbers up 150% over 2006, and 180 incidents of the more dangerous hemorrhagic form of the disease logged. Worries over dengue caused the Ministry of Health to deny a permit for celebration of the annual October Carnaval in Caribbean port city of Limón.
Pertussis, colloquially known as whooping cough, caused the deaths of four children early this year, spurring a nationwide vaccination and awareness campaign, which appeared to bring the situation under control.
Costa Rica more firmly positioned itself this year as a prime location for pharmaceutical and medical-equipment manufacturing.
Allergan opened a plant near Heredia to manufacture silicone breast implants and surgical balloon implants to treat morbid obesity.
Bayer’s international acquisition this year of pharmaceutical corporation Schering Pharma meant a boon for Costa Rica, which now hosts the combined company’s Central American headquarters. And the Chicagobased Hospira announced a $9 million expansion of existing drug-manufacturing operations in Costa Rica.
And U.S. company Homewatch Caregivers opened its first Latin America branch here in January, offering everything from home nursing services and personal hygienic care to assistance with grocery shopping and laundry.

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