Physical Therapy in the CAJA

The CAJA is Costa Rica's medical care system. That provides mediocre medical care, at a low cost. That is works at all, is amazing - and it is hardly surprising, that it works inefficiently.

Its basic operational entity are small clinics, in every town, called an EBAIS. The one in Orosi, the little town I live in - actually has two of them, in the same building. The basic idea, of providing medical care, in these small, local organizations is a sound one.

More demanding medical care is provided by regional hospitals. But the way at these hospitals work, is very complicated - unnecessarily so. It has been decided, that Physical Therapy will be performed at these hospitals only.

If you are not fluent in Spanish (which I am not) finding the right care at a hospital, requires the assistance of someone who is fluent in Spanish. And this has been provided by Ray, who owns the house I live in. I rent the apartment in the back of our house, and he uses my rental money, to make the payments for the whole house.

This arrangement has worked well, until recently. When I broke my upper arm, and the hospital fitted me with a complicated device, that immobilized by arm, so it could heal. It did heal, and the hospital decided, I needed to follow up with Physical Therapy. and set up an appointment for me to do this - at the hospital, which is a one-hour bus ride from the town where I live,

I can ride the bus, and take a taxi to the hospital. But when I get there, I cannot tell what to do next - since I speak no Spanish.

Ray found a man with a car, that would take me to the hospital, and do the navigating for me. But he was expensive, and this late in the month - I had no money. Ray even agreed, to loan me the money, so I could go to my Physical Therapy appointment. I made a mistake, and did not accept the loan.

I cannot say, why I was so stubborn about this - but the decision was made, and it cannot be reversed. I will have to do without Physical Therapy - since it cannot be provided by the EBAIS.