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Vampire bats and moonshine

BMJ 2003; 327 doi: https://doi.org/10.1136/sbmj.0307245 (Published 01 July 2003) Cite this as: BMJ 2003;327:0307245
  1. Mohit Kaushal, third year medical student1,
  2. Christopher Niranjan, third year medical student1
  1. 1Imperial College, London

Mohit Kaushal and Christopher Niranjan went to Costa Rica for their elective and found that effective health care is more than clinical skills

We did our elective in an indigenous reservation in Central America. The Native Indian Reservation covers a huge expanse of land stretching from eastern Costa Rica all the way into Panama. Although the rainforests and mountains make the area visually stunning, the land is relatively infertile and is unsuitable for farming, which further exacerbates poverty.

KENT GILBERT/AP

There are an estimated 8000 Indians living in various settlements throughout the reservation. The Indians have been in this area for centuries and are believed to have originally come from inland Asia; genetic studies have shown them to be related to similar tribes in Outer Mongolia. They are nomadic people and move settlement on average every 9-18 months, frequently moving between the two countries across a border that does not exist on their reservation.

Travelling on horseback

You can drive to the edge of the reservation, but, inside it, the only forms of transport available to us were horses (where permitted) or simply trekking on foot. The healthcare team that travels through the reservation to the various outreach …

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