While justifiably scary to most parents, the numbers themselves are small  Still, it bears spending some time learning about this parasite.

Basically, the whole process starts with rats. Rats become infected and pass larvae in their feces. Slugs and snails come in contact with the feces and they then become infected. The disease is passed to humans while eating undercooked snails or possibly on vegetables that either have small snails on them or perhaps have not been thoroughly washed. I say perhaps, because the Center for Disease Control (CDC) states “There is some question whether or not larvae can exit the infected mollusks in slime”.  Some here think that just contact with the slime of a slug can infect a person, maybe by just crawling around on a lettuce leaf, but clearly there is no proof of this. More likely would be ingesting a tiny snail in your salad.  Either way, wash those veggies!

I know little about escargot, but I know a ton of folks who dote on it. I tried it once and liked it, but then if you put enough garlic on a shoe, I’d probably like it equally. I also think special snails are used in preparing escargot.  Probably went to prep school or something… but just the same, I think thorough cooking is called for.

Kids, however, can find slugs and snails to be fascinating. They pick them up and think they might make fine pets.  A few weeks ago, however, a little boy (15 months) died after eating a slug. He passed after spending  two week in Childrens Hospital.. The larvae do just terrible things to a child’s intestines.

Interestingly, all of the kids involved lived either in San Jose or Alajuela. I say interestingly as, in general, Cost Rica’s normally nasty critters and bugs live on the coasts or the rain forests where the tropical heat provides a better environment.

This all starts with the rats, of course, so in addition to the cautions above, make sure there is no thriving rat population near you.

The incidence of dengue this year has more than doubled from 2006, according to the latest statistics from the Ministerio de Salud. So far this year the Caja Costarricense de Seguro Social (CCSS) and the ministry of Health have spent ¢1.5 billion colones (us$2.9 million dollars) attending patients and fumigating. Throughout the country more than 8,000 persons are ill. During the first 25 weeks of 2007, health officials said Friday that they logged 6,882 cases and two dengue-attributed deaths. During the same period in 2006, there were only 3,435 cases.

In Playas del Coco for example, it has been reported that the dengue virus has also affected the number of police available for service. The local Fuerza Pública captain, Johnny Fernández and two other officers were out for eight days. I am not sure how many staff that post, but I am betting this is about 80% of the entire police department. Local doctor Dr. Álvaro Ampié told the La Nación that he starts to see dengue patients from opening the doors at 7:00 AM and recently attended to 14 dengue patients by 2:30pm.

On the Caribbean side, the very popular Carnavale de Limón, held annually first week in October, is in danger of being canceled.

Health minister, María Luisa Ávila Agüero has stated that the popular carnival may be canceled if the number of cases of Dengue does not decrease within 2-3 weeks. She wants to see a 20% decrease in the number of new cases. The health ministry has a reported 3.413 cases of classic dengue and 40 cases of the far more dangerous hemorrhagic variety.

What is odd to me is that a BIG part of the problem is local hostility to those health workers who are spraying for mosquitoes in Limón centro. They have had numerous conflicts with local residents. I have NO idea what that is about, bit it seems like a pretty dumb idea to fight those charged with saving your bacon.

The Dengue mosquito only bites during fdaylight hours and use of repellent is very effective in reducing exposure.

For more information and articles, see:

http://www.therealcostarica.com/health_education_costa_rica/disease_costa_rica.html

http://blog.therealcostarica.com/2006/05/20/dengue-threat-and-other-stuff-for-travelers/

and

http://blog.therealcostarica.com/2005/12/05/traveling-to-costa-rica/

The doctor’s flute playing has improved. The first time he played for me, I was visiting him for an intestinal virus that knocked me down and bowled me over. A few years before, I’d had the same virus and suffered for a week until a conventional doctor found a drug that would work. I wasn’t going through that again, and since I had discovered acupuncture through a problem with my daughter’s teeth, I figured why not?

True, it costs some time and then there is the approximately $20.00 a visit and then there’s the flute playing, but it seems a rational, logical, and simple option to dabble with. And if it works: BRAVO! Problem solved. And if not: the doctors are always ready and willing to dispense the proper drug. So, in my book, why not give it a go.

I’d rather ramble down the road less traveled for a trip of pain relief rather than run right down the highway to the big beast of conventional medicine. – I’m not crazy, I don’ want it to go away. In fact – thank goodness it’s there! My son wouldn’t be alive without it. But I like to save their wisdom for the few and far between.

Last week, I got several massages in my home to help alleviate a pinched nerve in my neck. The woman came right to my home. The cost: $10.00 for each visit. This woman was so considerate and concerned about my neck that alone may have dissipated some of the tension. About half way through the massage, she leaned over and whispered in my ear:

Do you want me to put a chair on your back?

I looked around our cluttered guest room and wondered which chair she wanted to put on my back and how exactly a chair would help in solving my pinched nerve problem.

I repeated the word chair:

A silla? (pronouned seee ya)

She bent over and whispered again:

Arcilla (pronounced ar seee ya)

I thought for awhile….where did I know that word from? Oh yes, I know! It means clay -
she wanted to put a clay wrap on my back. Of course, I said. Clay.

The kink in my neck is gone; my daughter’s teeth are coming along beautifully; even that intestinal virus went away (the next day, and I’m not kidding!); and the little cysts in my neck will most likely dissolve with just a few more melodies on the flute.

“If he stays anemic, he might have cognitive learning problems,” said the doctor.

That statement will hit any parent right in the sternum. Trouble learning? MY KID was going to be different than all those other kids. The words mentally retarded already spun in my mind daily because every book on Trisomy 21 says that this group of children test low for intelligence level.

Funny thing….even with a child with Down Syndrome, I want Addison to be an above average boy. The need to fill our kids with information is a cultural line we’ve been hooked into. We show our kids videos of shiny objects; flash cards at their little faces; teach them where their fingers and toes are; count to ten in 14 languages; learn verb conjugation before toilet training; and possibly, learn the finesse it takes to make a crème brûlèe.

I’m kidding on the last one. But, I’ve slipped into all the traps, in one way or the other, in teaching, and hoping, my kid is going to rise above the cream. Meredith F. Small, a professor of anthropology at Cornell, who’s written several books about children and how we mold them into miniature models of ourselves and all that culture has imposed on us, said that kids are going to learn language at their own pace – no matter what we do to them. They learn by watching us, modeling us. We might get a four year old to sputter bigger words earlier, but he may not understand what “grizzled” means until he can understand the content of a story that needs a word such as grizzled.

I took my son for another blood test. I was grateful that it was only a pin prick to the finger, but his wailing would have suggested otherwise. The nurse put a Band-Aid on his tiny index finger.

“Be careful she,” she said. “He could swallow it.” Duh, I thought. Why don’t you just give him a sucker and tell him not to suck on it? Addison held up his finger like a prize all the way out to the car. I tried once to pull it off, but he quickly withdrew his finger and kicked liked a bucking bunny.

I told him he could have the bandage as long as he didn’t eat it. He resisted this information, and upon leaving the hospital, he had the thing in his mouth. I stopped the car and fished it out of his mouth. (He loves to hide paper, grass, etc. on the roof of his mouth.) He wailed again, but in less than a minute, he fell asleep. He slept for almost two hours in my car while it was parked in the garage. I guessed he’d needed to recover from all he had learned.

I have always questioned this whole concept as people are lulled into a false sense of security thinking that the 3,000 registered prostitutes are somehow less risky. It is my understanding though, that AIDs and some other diseases can take months the “show”, and thus, even a newly examined person may be infected and not know it or show positive in tests, But I digress….

Caja has detected some 4.000 cases of HIV in the country, but the real number could be as high as 15.000. As with anything that could remotely affect tourism, the facts may not be quite acuurately given. Transvestites that offer their services at night on the corners of the downtown streets are also of major concern.

Prostitution in Costa Rica is perfectly legal, but procuring (pimping) is not. Thus, as sexual tourism is, like it or not, an important part of Costa Rica tourism industry, I want to provide warning to any visitor that you should NOT trust the “system” to protect you. Protect yourself!

My contact with Costa Rica began as a tourist. Helen Keller said that life is a daring adventure or nothing at all. So in 1998, I took the leap and moved here in search of a less hectic life. A few other reasons may have swayed my decision. Perhaps living in the United States left me a little sour, prickly around the edges. My physical health a wreck, I hoped paradise would deliver me a little closer to fine.

Living in Costa Rica is not a panacea for all my woes; I still had to make money to eat. But little by little, the stress ebbed; my life began to flow. After much introspection and a lot more visits to the psychiatrist, I began to free myself from the tension and turmoil that consumed me in the United States.

My story is not much different than the thousands of other expatriates who’ve come to Costa Rica. I rolled up my sleeves and faced the bureaucracy; waited in line for stamps and documents. I survived scorpions, snakes, the phone company, the water company, and the traffic.

Then, I went and had couple of kids. Having children messes up everything – I rarely get to movies; my fridge is full of pureed blobs of food; I sleep like a cat in a tree – always balancing precariously with one eye open, waiting for trouble to stalk me.

But the funny thing is, these children have saved me. Children have also thrown me into a deeper relationship with the country. I’ve seen the inside of hospitals, the underside of playgrounds, and the ups-and-downs of education, health, and immigration.

My stories are about parenting and the struggle to find a semblance of some sort of SELF. Latin America is a different ballgame than the U.S., Canada, or Europe; Costa Rica is a bit different than much of Latin America. But it’s a gem, sometimes it rubs the wrong way but nonetheless, shines.

As you might expect, I get a lot of email from people who are either making the move to Costa Rica or are considering such a move. Some are baby boomers realizing that they may not be able to afford to retire in their home country… others are younger, asking about employment opportunities and lifestyle. They ask my advice on a variety of things,and I give the best answers I can. But over time, I have come to realize that there are a some questions that are never asked, but certainly should be asked, before making a move of this magnitude.

So here are my thoughts on this.

One fact that is pretty well agreed upon is that from 30 to 40% of the people who move here do not make it through the first year. They return to their home country. I read an unsubstantiated article the other day that says this figure is average even for those moving to Hawaii. I guess it is the leaving your home soil that makes it hard… Quien Sabe?

I think that to approach this topic clearly, the only logical place to begin is by dividing everyone into groups. The way to do this is by age, I suppose, so I am going to (arbitrarily) use age 50 as the cutoff. The reason is that those under 50 are probably not retiring. Their needs are different than the over-50 crowd who are a bit more likely to be either in early retirement or will be retiring pretty soon. Obviously your personal situation will vary, so I suggest your read both sections.

Of these two groups, the over 50 crowd is much larger, so I will begin with them.

Over 50

Costa Rica has become one of the hotspots for those of or nearing retirement age who are coming to the realization that they may not be able to afford to retire on social security or another pension plan, so they are now casting about for alternatives. Of course there are also those who have no money concerns who are also considering the expatriate life. The interesting thing is that the most important things to consider for all these people are pretty much the same.

Leaving Home

Sounds simple right? It is not. You are leaving home.

You are leaving everything behind that is “normal”, comfortable, and familiar. You are leaving behind family and friends. You may be leaving behind your children… and their children… the grandkids. If you have money, you can visit them of course, and they can visit you, but maybe not so often as they likely have to work and vacation time is limited. You will probably miss births, first communions, bar mitzvahs, baptisms, accidents, first steps, first words and a ton of the other daily “stuff” that makes up your life. Of course you will hear about all this stuff… after the fact.

If one of your good friends needs your help or your daughter is fighting with her husband, you will not be there to advise or provide a shoulder. It must be done long distance. It is not the same.

Can you handle that? For Pete’s sake don’t say yes if the answer is no.

Costa Rica is not for everyone. It is not the panacea to your problems. It is not like the tourist Costa Rica that you may have experienced on a visit. Nearly every single thing you do in this country is different from how you do it at “home”. Going to the pharmacy, shopping, learning the names of all your body parts and car parts so you feel comfortable at the doctor’s office or the mechanic, getting your hair cut or going to the beauty parlor, learning the metric system for groceries and cooking, stopping at the bank, going to the movies… the list is endless.

Analyze why you are leaving. Have good reasons? I hope so. For instance, I get a ton of email from people who cannot live one more minute under the George W. Bush regime. I am starting to get emails saying that if Hillary Clinton (or almost any other Democrat) is elected, they are leaving the USA. HUH? Do you think things will be different here? Nothing changes. You are just leaving your family and friends to live here and you STILL will have to deal with all the political crapola that IS the United States… and Costa Rica!

Political reasons aside… I cannot tell you how many people I know who have underestimated the above. It is, however, one of the things that you should think about very seriously before you consider leaving home. Some folks can take it. Others simply cannot.

Where will you live?

This is the number one question on peoples minds. They want to get here, buy a home and get settled in. Kind of olde age nesting instinct I guess. Safety in your own little place. Right?

It is my opinion that this probably the last thing you should be doing! What you need to realize is that there is a fairly high probability that you won’t even want to stay here. That 30-40% number is something you should not ignore. If your doctor told you that you had a 30-40% chance of dying in six months, I betcha that you’d listen up pretty carefully.

So you come here anyway and quickly buy your little piece of paradise. Then realize any or all of the following:

• You vastly overpaid because you had NO idea what you were doing
• You chose the wrong location and now wish you could live in XXX (XXX is anywhere where you are not now living)
• You realize you just cannot live this far away from your grandbabies, friends, family… etc.
• You realize that to really enjoy living here, you really have to learn Spanish
• You cannot adjust to the Latin lifestyle
• You THOUGHT is was cheap to live here, but as you chose to live in high security, gated communities in some Gringo stronghold, you now find yourself paying more than it would cost to live in Miami
• You decide that Costa Rica is not for you and then realize you have no place to go. Your money is tied up in your overpriced home which cannot be easily sold, and you have no home to return to anyway.

I could add another 5-6 items to that list, but I hope you get the point. Do not rush into the expat life. Personally, I love it! Others do not.

What to do?

Stop and Plan this thing.

By all means come here and try it out! There is little or no downside IF you don’t do anything drastic.

If possible, don’t liquidate everything in your home country. Don’t sell the farm. Rent out the old homestead. Have someone housesit. THEN

Come here and RENT for the first six months to a year. This will give you the opportunity to travel all over the country and see what are your options. Meanwhile, your CASH and your property are safely sitting somewhere so that if you DO change your mind, you can get out easily and relatively painlessly.

My wife and I like to take little weekend jaunts, and I can tell you this: After living here for several years and visiting here for even more years, there is not a month that goes by that we do not say to each other, “Let’s buy a place here. This is GREAT!” We must have 25 places we’d like to live someday.

Costa Rica is rich with beautiful locations. There are of course the famous Pacific beaches, but there are Caribbean beaches, mountains, valleys, rain forests… You must really know Costa Rica to have any idea what will be best for you. Other considerations:

• Do you want or need access to shopping? Internet? Other things (aka infrastructure)
• Over 50? Things start to break on people over 50. The beaches, while beautiful, have little or no access to good medical care. No trauma centers. The closest beaches are about 2 hours from a good hospital. Even more if you are in Guanacaste. It can be just as bad from the mountains. Is this important to you? Should it be?
• Do you like movies? The Orchestra? Cultural stuff? San Jose has it. An easy drive from the mountains surrounding the central valley. A really LONG drive from any beach community.
• You like the heat? Lots of folks do. But they are not prepared for living in 90 degree heat WITH 80-90% humidity. This is the tropics so you better know you like it before you make the big move.
• Insurance? Costa Rica is famous for it reasonable medical care, BUT are you prepared for the downsides of any socialized medical care? HUGE waits, delays in getting prescriptions, overcrowded and understaffed public hospitals that may not have even BASIC life saving smoke detectors? The terrible condition of some of those CAJA hospitals?

Again, I can go on forever, but you get the point. There is no rush. Relax. Get to know Costa Rica. Learn some Spanish. See if you can adjust. Travel. THEN, make your decisions from a position of power and knowledge.

And as for those realtors making it sound like this is your last chance to buy land… remember there is a lot of paradise here… and it will all be on sale next year!

But if you think you can handle all this.. Come’on down. At the least, it will be a life changing experience for you and your family, and if you plan it correctly, there will be little or no downside to the adventure!

This is the end of Part One.

Part Two for the Under 50 crowd will be up in a thrice!