stem cell clinic in Panama City

The Institute of Cellular Medicine (ICM) in San José, Costa Rica, which opened in 2006 and has treated hundreds of people, recently shut down its clinic.

The company’s Panama City stem cell clinic is still open.

An article on the Popular Science blog says that the Costa Rican health ministry stopped ICM’s stem cell treatments because there is no hard scientific evidence indicating that the treatments work. But a comment on that same post (apparently from someone at ICM) offers the alternate view that “the ‘closure’ of the clinic was a business decision by the company to consolidate operations.”

Stem cell treatments, which introduce new cells into damaged tissue in order to treat a disease or injury, have both been hailed as the new wave in medicine and vilified as a scam preying on desperate people. Such treatments have not been approved by the U.S. Food and Drug Administration, meaning they have not undergone the lengthy human clinical trials that would allow such federal approval.

Popular Science also has an interesting article about stem cell tourism in general, focusing on treatments available in the Dominican Republic. “Droves of patients are heading overseas for stem-cell therapies unavailable in the U.S,” says the article. “ Is it a dangerous scam — or is America just behind the curve?”

Looking out from San Lucas Island towards the Nicoya Peninsula. Photo: Erin Van Rheenen

Did you know that there are at least three recognized travel-related maladies associated with well-known cities?

All can be grouped under the heading of Voyager Syndrome, the wonderfully poetic term for (mostly psychological) illnesses related to travel.

Paris Syndrome occurs when the reality of the modern French capital clashes with a visitor’s idealized expectations (Japanese female tourists in their 30s are at the highest risk). Jerusalem Syndrome is characterized by a sudden flaring up of extreme religious feeling, and can affect Jews, Christians, and Muslims, or even travelers who consider themselves irreligious. Florence Syndrome (also known as Hyperkulturemia, or Stendahl Syndrome, for the author who first described it) can strike travelers exposed to beautiful art, especially a lot of it in one place, like at Florence’s Uffizi Gallery; symptoms include dizziness, faintness, palpitations, and hallucinations.

As I contemplated these various syndromes, I wondered: what would a “Costa Rica Syndrome” look like?

Having interviewed a fair number of foreign residents, I can think of at least one possibility: a sudden and profound belief that you can communicate with monkeys, or turtles, or (this one’s trickier) crocodiles. Many of us in pavement-heavy realms live with Nature Deficit Disorder. Coming to Costa Rica, where nature is very much front and center, can be almost overwhelming. The drippy tropical tangle of the rainforest. The cacophony of a forest full of birds. Beaches where the only sound is the salty slam of wave on sand.

What’s your idea for the Costa Rica Syndrome?

More on the various Voyager Syndromes

More on what a San Francisco Syndrome might look like

Costa Rican streets aren't kind to wheelchair users. Photo: Erin Van Rheenen

She took the ball and ran with it, writing on her blog that PASE isn’t “just a splinter group supported entirely by the disabled population; but instead a driving force in Costa Rica politics with a substantial mainstream following.” And Candy poses a provocative question: “If a relatively inaccessible country like Costa Rica can have a political party based on inclusion, then why can’t it happen in an accessible country like US? And if it did, could this type of a party actually garner a solid mainstream following?”

Two things you don't often see in Costa Rica: special parking for disabled drivers, and 'Prohibido fumar' (No Smoking) signs. These are in front of a government building in downtown San José. Photo: Van Rheenen

Of course the fact that Costa Rica has a political party that advocates for wheelchair users could also be an indication of just how how far the country needs to come in that area.

Costa Rica’s streets and sidewalks are challenging enough for able-bodied walkers, who must be on the lookout for ankle-breaking holes, deep gutters, and careening cars. Wheelchair users in this country have to be especially resilient and creative, as they won’t find many ramps to help them over curbs or lifts to get them on buses.  On the other hand I’ve seen strangers pitch in to help when a wheelchair needed to get over a high curb or a wheelchair user needed to be loaded into a car or bus.

PASE recently won 4 seats in Costa Rica’s Legislative Assembly. I’ll be curious to see if  the landscape will change for local and visiting “wheelers.”

private hospital in Costa Rica

During his March 8 show, conservative radio celeb Rush Limbaugh said that if the current U.S. health care reform is approved, he would move to Costa Rica.

He seems to have evoked Costa Rica as a place where there’s less “government intervention in health care,” but of course Costa Rica has more “intervention” in providing medical care for its citizens than does the U.S.

Igor Volsky, writing for WonkRoom, put it well:

“But unbeknownst to Rush, Costa Rica’s hybrid government-private health care system provides comprehensive universal coverage to all residents – and even sells affordable policies to soon-to-be visitors like Limbaugh. The government owns several major public hospitals and operates small clinics in almost every community. Workers are required to contribute 15% of their salaries to health insurance and the unemployed “obtain public funding for all health services, including prescription drugs.” At least a third of all Costa Rican residents receive some care in the private sector and the government regularly purchases services from private providers. The system is not without its problems, but it boasts a higher ranking from the World Health Organization – Costa Rica is 36, United States 37 – and has higher life expectancy and lower infant mortality rates. Costa Rica also spends less per capita on health care than the United States and insures almost all of its residents.”

In his ignorance of Costa Rica, Rush inadvertently endorses a system that he spends a great deal of air time vilifying. Sure, Rush, come to Costa Rica–you’ll see how a tiny country with fewer resources than the U.S. makes health care a priority for its people.

More information:

The basics of Costa Rican health care

Four expats weigh in on public and private care in Costa Rica

A public hospital in San José, Costa Rica

With the new immigration reforms that go into effect in Costa Rica next week, it looks like expats who are legal residents in Costa Rica must enroll in the national healthcare system,  the Caja Costarricense de Seguro Social. Known  as the Caja, the system gives its members low-cost access to neighborhood clinics, pharmacies, and public hospitals.

Some Costa Rica expats are satisfied with Caja (public) care; others are most definitely not.

Visit Miss Move Abroad to read one whole-hearted and one half-hearted endorsement of the Caja, and two accounts of what can only be termed ordeals at public hospitals.

The crossroads in Liberia, fast food haven; photo by David W. Smith

In the hottest town in Costa Rica I saw a doctor about my ear problems. They’d been feeling plugged up for weeks. We were staying right in town, so I just wandered around and found Clinica San Rafael Arcangel, which looked clean and professional and had an air-conditioned waiting room.

A head and neck specialist (cirujano de cabeza y cuello) could see me that afternoon, so I paid my 30,000 colones (about $60) for the initial consultation, surprised at the high price. Costa Ricans I spoke with in the waiting room said they had paid the same for an initial consultations–it was worth it to them not to have to endure the long waits at the Caja, the national health care system.

I saw Dr. Carlos Granera Umana, who had trained in San Jose but relocated to Guanacaste early in his professional career. He liked everything about the place except the heat. “Stay inside in the middle of the day,” he counseled.

And the price?

“We’ve been charging that for years and are about ready to raise the prices. A lot of middle class professional have moved to Liberia from San Jose and for them, the rate is not an issue.”

Dr. Granera was kind and gentle and he managed to unplug one ear and make the other one a little better. I’ll check out more medical care in San Jose and David might see a dentist here.

Costa Rica-style directions to the Clinica San Rafael Archangel in Liberia:

from the Escuela Asucion Esquivel, go 100 meters  East and then 75 South.

Telephone: 2666-1717

Alex Murray working on his deck after being released from the hospital.

Alex Murray was burning trash at his home near Lake Arenal in Costa Rica when the fire flared up and burned him over 20% of his body.

He spent the next 20 days in 2 Costa Rican hospitals, the first public (Hospital San Juan de Dios), the second private (Clinica Biblica).

Alex is one of four expats featured in this in-depth look at public and private hospitals in Costa Rica.