Anticipation of Wednesday night's World Cup soccer qualifier against the United States is mounting.

The U.S. team arrived on Monday and has spent the last two days sinking their cleats into the artificial turf at Ricardo Saprissa Stadium in Tibás, north of San José, and mentally preparing from their hotel rooms at the Hotel Real Intercontinental in Escazú, west of the capital. Meanwhile, Costa Rica National Team La Sele has been running through tactical plays and preparing to launch a strong offense.

Though the United States is coming into the match with the upper hand – they're currently ranked first in the qualifying tournament – they face a curse which has haunted them whenever they set foot on Costa Rican soil.

The U.S. has never won a game on the road against La Sele in the last 20 years.

“We know the game will be very difficult. That is clear,” said U.S. player Landon Donovan, who has played qualifying games in Costa Rica before and leads the team with 108 international appearances. “My first game here was very difficult and I learned much. Now, we are well prepared for what will come. We expect a good game.”

The artificial turf field and deafening stands will also be a hurdle for the U.S., which is unaccustomed to playing on fake grass.

Yet, Donovan is undeterred by the field and looking forward to the fanfare that typically accompanies big games in Latin American countries.

“For me, the crowds are fun,” he said, speaking to the press in the Spanish he picked up from childhood teammates in California. “For the younger players, it may be a little difficult. But for me, it's better than having no one in the stands.”

He added, “When people talk about the challenges of tomorrow night's match, we name the turf, the people, but it's also the team. Costa Rica has a great team, one that plays very well.”

La Sele coach Rodrigo Kenton echoed the compliment, saying the United States “is a very organized team, which comes through in the team's transition from defense to attack.

Costa Rica is currently ranked second in the World Cup qualifying group with six points. (The United States has seven, after three games.) Each team plays 10 games and the top three will proceed to the 2010 FIFA World Cup in South Africa.

The fact that Costa Rica is in the top 10 among its Latin American neighbors in almost every health statistic – according to a recent report from the World Health Organization -- is no surprise to medical experts here.

This little country of 4 million provides coverage to more than 90 percent of its residents, gives access to 100 percent of those living within its borders and caters to a population with a heightened concern about health. As a result, it has some of the lowest mortality rates among children under five, pregnant mothers and malaria patients; and ascends to the top of the list for access to improved sanitation and clean drinking water.

“It's an excellent system,” said Isaac Waserstein, a leader in the pharmaceutical business, who has spent more than 30 years watching Costa Rica's medical industry. “Results show that we have a health system that is working. Can it be more efficient? Sure. But we are doing a good job.”

Yet, in a medical landscape that is constantly changing, some wonder whether Costa Rica can maintain its successes.

Costa Rica's population is growing older and technology is changing rapidly, two factors which drive up costs and make it difficult for the country to maintain its level of services. Insurance companies are beginning to set roots here, thanks to the Central American Free Trade Agreement with the United States, which adds a new dimension to the equation.

The country's health system faces many challenges in the future, including providing private-level care on the public dime and keeping pace with technological advances, but, if Costa Rica maintains its public health system, Waserstein is confident the country will continue to top the list of health statistics.

“The theme of medicine in the world is that it is expensive. It's not a penny business,” said Waserstein, president of Stein Inc., a pharmaceutical company. “What makes it more expensive today than 20 or 30 years ago is technology and the fact that more people are using the system. They are living longer so they are using the system more.”

At least one area that Costa Rica falls behind, according to the recent report, is in the number of its teenage girls who are pregnant. Statistics show that 63 of every 1,000 girls between the ages 15 and 19 are or have been pregnant – slightly above the average for the Americas as a whole (see chart).

This is more of a social issue than a medical one, said Waserstein, but he blames a loss in family values for adolescent pregnancies.

For the full World Health Organization report in English, click here.

SAN PEDRO SULA, Honduras – One little island of under 11.5 million people has dominated the discussion of a meeting between dozens of heads of state and government officials this week.

Though the theme of the 39th General Assembly of the Organization of American States (OAS) was intended to be violence in the Americas, many Latin American leaders directed their comments to relations with Cuba.

Honduran President Manuel Zelaya called for a repeal of the 1962 resolution that suspended the group's relations with Cuba as a result of its communist ties, saying that if this assembly fails to do so, member countries would be “accomplices to a mistake made 47 years ago.”

Much of the criticism was directed at the United States, which expressed resistance to the idea of Cuba rejoining the regional group without instituting democratic reforms.

Former first lady and Secretary of State Hilary Clinton called for a change in Cuba's political structure like that of El Salvador this week, when presidencies peacefully changed hands between right-leaning Antonio Saca and left-leaning Mauricio Funes.

“We believe it is in the best interests of the Cuban people and our region (for Cuba) to be more integrated in the region,” Clinton said. “We think that there is an opportunity for Cuba to be more involved, but at the same time, we want to see the peaceful transfer of power that we saw this morning (in El Salvador) possible for the Cuban people.”

She pointed out current President Barack Obama has done more in the last four months to improve U.S.-Cuba relations than has been done in the last eight years.

In a directive issued in early April, Obama called on U.S. telecommunications network providers to establish connections between the two countries, sought to ease rules against family travel to and from Cuba and pressed for the removal of restrictions on money that can be sent to Cuban family members (TT, Apr. 3).

Tuesday's criticism followed another blow the United States received late last month, when Venezuela and Ecuador threatened to leave the OAS and proposed the creation of a new organization without the United States.

Foreign ministers ended the first session of the two-day assembly by creating a working group aimed at assessing the suspension levelled against Cuba.

Prices in Costa Rica are dropping for the first time in almost a decade at a rate of 0.12 percent throughout May, according to data released Tuesday by the National Statistics and Census Institute (INEC).

The Institute's Consumer Price Index (IPC) shows an increase in frugality, as people try and save more in case of hardships they could possibly face in the future, said Manuel Chávez, a statistical technician with INEC.

“What the people are buying and what they're spending is only for the basics,” Chávez said. “If I still produce a lot, but people are not buying, then prices are going to drop.”

Since January, the index is still up, with just over 1 percent inflation, the IPC indicated. Over the past 12 months, however, the index has still posted an increase of more than 9 percent – indicating the heights from which the inflation rate has fallen.

Prices fell overall throughout May, with every indicator – from food and beverages to transport and health – hovering just below or above zero.

The variation shown in the IPC is a natural outcome of the current economic difficulties, Chávez said, and prices should begin to increase as security makes its way back into the consumers' mindsets and bank accounts.