Doctors and nurses assigned to two public health clinics in the Northern Zone of Costa Rica were busy cleaning and painting instead of looking after patients after cockroaches and mice were reported in their facilities. The clinics were closed on two separate Fridays: May 25^th and June 1^st.

According to digital newspaper El Pais, patients were extremely aggravated by the closures. One patient commented that her husband stood in line at 3:00 am to get an appointment for their son, who was experiencing vomiting and diarrhea. At 7:00 am, the man was told the clinic would be closed for cleaning and maintenance that day. The family ended up taking the child to the hospital in Liberia.

Many public health care clinics in Costa Rica have changed their operation schedules and intake procedures to limit the number of patients they treat each day. For this reason, some patients stand in line in the early morning hours to lay claim to a coveted ticket that guarantees they will be seen that day. In some rural clinics, only 25 tickets are handed out each day.

The two Basic Acute Health Care Clinics (EBAIS in Spanish) mentioned above are located in the community of Belen, in the Carrillo canton of the Guanacaste province. Both facilities are administered by La Caja, Costa Rica’s once lauded, but now ailing, public health care system. The EBAIS centers are integral to public health, as they are often the first step of the medical treatment system for non-urgent conditions. EBAIS centers located in rural communities such as those in the Carrillo are critical since they alleviate the patient loads experienced at hospitals in larger urban centers like Liberia.

El Pais questioned the director of the Carrillo Health Care area Eva Camargo Batista on the matter, Ms. Camargo admitted to the rodent and roach infestations, and added that medical personnel including doctors, nurses, medical clerks, and even the chief of logistics picked up brooms and paint brushes and got to work. A representative from the central auditing department of La Caja observed the cleanup and painting.

Bad Timing and a List of Demands

The patients interviewed by Don Edgar Canton for El Pais explained that the clinic closures were poorly planned, particularly since Costa Rica is now in the midst of her rainy season, a situation that exacerbates infections in children. The Costa Rica Star recently reported on this seasonal risk of intestinal parasites.

Mr. Canton also reported on the demands that the community will present to La Caja following the clinic closures. They want answers on the following:

• The EBAIS centers used to close at 10:00 pm, now they close at 5:00 pm. Why?
• Why did the cleanup and painting take place on two Fridays rather than on weekends, when the clinics are closed?
• How much was invested on the cleanup and painting?
• How much were the medical staff paid while they cleaned and painted the EBAIS centers?
• How much would have cost to contract professional cleaners and painters instead?