Final Reflections on the Costa Rica Experience

Posted on August 21,2012 by latinomentalhealth

This is Eleonora, Carla and Oren reporting final reflections on the Costa Rica experience.

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El Fin

Posted on August 21,2012 by latinomentalhealth

This is Kiley, Jill, and Lisa blogging at the conclusion of our trip to Costa Rica.
As our time in Costa Rica draws to a close, we have come to a number of conclusions about the experience that we are excited to share. It is, however, difficult to articulate ours experience fully, as the act of immersing oneself in another culture for four weeks has great implications that will no doubt extend far beyond today.
While one of our main goals in coming to Costa Rica was to enhance our Spanish speaking abilities for use in a clinical setting, one unanticipated factor that was gleaned from our immersion experience is realizing the ways in which elements of the culture of a developing country permeate all areas of life for the people. While we have found that, in many ways, Costa Rica offers its citizens access to sufficient (often excellent) mental health care, education, and other social services, there are indeed areas in which the systems struggle to meet the need efficiently and effectively. The system is complex and bound by many sociocultural factors that we would not have formerly recognized as contenders.
We do not mean to say that the system is entirely flawed or that the people are consistently for want or need of services. We mean to say that in our analysis of the system, we need to keep in mind that Costa Rica is a developing country and has challenges of a developing country. We also cannot forget that we are observing from the lens of Students from the United States. Many Ticos with whom we spoke had wonderful stories of success with the healthcare and/or education system. We were also reminded that the Costa Rican people are living to ages that often exceed average lifespans of people in the United States.
We have been so consistently impressed by the skills, intellect, compassion, interest, hospitality, and honesty that we have witnessed in the people we have interacted with during our time here. One example of the compassion of the Costa Ricans was with a child and mother at the UNIBE clinic. The child was receiving Cognitive Evaluation and the mother needed to bring her to the clinic on five separate occasions for the assessment. After the third session, the mother, who is a house keeper, was nervous she would lose her job if she missed any additional days at work. The clinician changed her times and extended sessions in order to accommodate the needs of the family.
At times, it has been difficult to witness the ways in which personal and professional lives are impacted by the limitations that life in Costa Rica imposes. However, for every one of those times, we have been impressed by the great importance placed on securing and maintaining good health (both physical and mental) for the people of a country that struggles so financially.
In short, the experience has been far more thought provoking than we could have anticipated. We arrived hoping to speak better Spanish and we are departing with a host of new ideas and impressions about mental healthcare in Latin America. Thanks for following our blog! Until next year!

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Adios from Ecuador

Posted on August 18,2012 by latinomentalhealth

Buenos Noches MSPP, this is John Pratico blogging during our last night in Guayaquil, Ecuador. We have had an incredible, amazing experience that none of us will likely forget. Last night, we went out to a local restaurant with Carla and Kelly's host family and were given our last servings of ceviche, platanos fritos (fried plantain chips) and arroz con carne. All of the dishes were delicious, as well as the impromptu salsa dancing lessons that followed.

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Semana #3

Posted on August 14,2012 by latinomentalhealth

Hola aqui le escribimos Carla, Eleonora y Oren. Otra semana llena de aprendizaje, aqui en Costa Rica. Durante esta semana tuvimos la oportunidad de asistir a la escuela de la comunidad Miguel Obregon, hacer rotaciones en el Hospital Calderon Guardia, recibir clases de hipnosis con la Dr. Paula Llobet y hasta de disfrutar de un fin de semana de ensueño en los bellos paisajes de Costa Rica.

Comenzamos esta semana visitando la escuela Miguel Obregon, donde tuvimos la experiencia de interactuar y convivir por varias horas con ninos de primaria. Ademas de sentirnos ninos por un dia y llenos de energia, pudimos ser testigos de la experiencia educativa que los estudiantes de Costa Rica aprenden, juegan, y hasta interactuan unos con otros. Algo que desperto mucho mi atención fue el observar la madurez y el nivel de capacidad que tenían muchos de estos estudiantes de primer, segundo y cuarto grado, que tuvimos la oportunidad de observar durante estos días. Por otra parte, pudimos observar la gran diferencia entre escuelas en los Estados Unidos y esta escuela aquí, en Costa Rica. Algunas de las diferencias que pudimos ver es el gran nivel de ninos que repiten el grado y la ausencia de personal cualificado para trabajar con ninos con deficiencias. Claro, esto es algo que se puede observar en muchas partes del mundo, e incluso en los Estados Unidos, pero esto solo habla de la gran necesidad de recursos que muchas veces podemos notar países latinoamericanos en desarrollo. En definitiva, la experiencia en la escuela fue increíble, y me hizo sentir útil y muy feliz el jugar y compartir con los ninos.

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Final Reflections of Costa Rica

Posted on August 14,2012 by latinomentalhealth

This is Becca W, Valerie, and Zach checking in and writing their last entry from Costa Rica.

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Tagged Latino Mental Health

Semana 3: Terapia Rápida y Eficaz

Posted on August 14,2012 by latinomentalhealth

Hola, somos Marisol, Curt, y Rebecca T. desde San José, Costa Rica después de acabar el tercer semana. Estuvimos en el clínica neuropsicológico observando terapia individual de adultos y también evaluaciones psicológicos con tres niños de varias edades. También tuvimos una clase de meditación e imágenes guilladas. Dos clientes de esta semana tenía problemas distintas pero las psicóloga utilizó el mismo tratamiento para los dos. Una de los clientes tenía problemas con el insomnio y la otra con una fobia profunda y debilitante.

La psicóloga decidió usar estos tratamientos inmediatamente en las primeras sesiones para darles habilidades en controlar su propio nivel de ansiedad. También les dio un disco de relajación hecho por la psicóloga para que ellas pudieran empezar a relajarse con su voz después de la entrevista. La doctora nos explicó que en Costa Rica, típicamente, se atienden los clientes sólo entre tres a seis sesiones. Por está razón es muy importante proveer las técnicas o habilidades necesarias para realizar cambios lo más pronto sea posible.

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Week 3 Costa Rica

Posted on August 13,2012 by latinomentalhealth

Hello,
This is Lisa, Jill and Kiley giving you an update on our immersion trip in Costa Rica. We had a very busy week visiting the neuropsychological clinic at UNIBE, learning and improving our Spanish, volunteering at an elementary school, and attending a lecture on mental health in Costa Rica. Given that other students have focused their blog on the neuropsychological rotation and the lecture, this blog will primary focus on our time volunteering at the elementary school.

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Education in Ecuador: Week three by Carla

Posted on August 13,2012 by latinomentalhealth

Three weeks into our experience in Ecuador and our group spent time in an elementary school. The classrooms were divided by grades but there were no windows and the doors opened to a courtyard shared by everyone. The teachers were eager to have MSPP students evaluating some of their children. We were limited in the time we spent evaluating each child with each visit lasting about thirty minutes. With so much work to be done, I hope that our experience this year can be built upon by future Latino Mental Health participants. Similar to my experience at the Crecer Foundation, my time at the elementary school strengthened my belief that despite all our differences culturally and otherwise, as humans, we have more similarities than differences. The children were playful and fun to spend time with.

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Tagged Latino Mental Health

Escuela Velazco Ibarra & Banos

Posted on August 13,2012 by latinomentalhealth

Buenos dias. This is Kelly reporting from Ecuador.

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Tagged Latino Mental Health

Hypnosis with Dr. Paula Llobert

Posted on August 13,2012 by latinomentalhealth

Greetings from Costa Rica! This is Tatiana, Alexandra, and Jessica reporting in on Week 3 of our immersion. This week during our clinical session, Dr. Paula Llobert instructed us in the art of hypnosis and guided imagery. I (Tatiana) have never been a fan of hypnosis, but that could have been due to my lack of knowledge about it. When individuals think of the word hypnosis, more than often an image of a doctor waving a watch on a string in front of a half-sleeping patient comes to mind. Many of us have also been to hypnotist shows in which a panel of individuals are hypnotized and then told to do ridiculous things at the sound of a bell. What many individuals do not know are the skills required to deepen a patient into a state of trance in which they feel more in-tune with themselves.

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Juvenile Detention Center

Posted on August 10,2012 by latinomentalhealth

Hola! This is Dot, Brian, and Elena reporting from San José, Costa Rica. This week we had the opportunity to take a tour of the largest juvenile detention center in Costa Rica and learn more about the Costa Rican justice system. The center houses over 200 inmates, nearly all of which are male. Although it is a juvenile facility, minors who turn 18 during their sentence are permitted to finish out their term at the center. Therefore, this center is home to 12 year old inmates as well as some in their late 20s. Our guide described some of the challenges posed by having such a wide range of ages in one facility. Not only are there different living quarters for minors and adults, but they also make an effort to keep them separate during most daily activities. She informed us that they are hoping that the law will be revised soon, as it is very difficult to meet the educational, medical, and psychological needs of such a wide range of ages.

Another interesting fact that we learned about the Costa Rican justice system is that, unlike in the United States, there is no such thing as a “life sentence” in Costa Rica. The maximum sentence for any crime committed by an adult is 50 years in prison, and the maximum sentence for any crime committed by a minor is 15 years in prison. We were somewhat surprised to hear that the two most common crimes that had landed juveniles in the detention center were robbery and homicide. However, our guide explained to us that because the maximum penalty is so much less severe for minors, it is not uncommon for children to be paid by adults to commit homicides.

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Tagged Latino Mental Health

Mental Health in Costa Rica: Week 2

Posted on August 10,2012 by latinomentalhealth

This is Zac, Valerie, and Rebecca writing from San Jose, Costa Rica. This week we got to enjoy some amazing activities provided by Carla and the Unibe staff. This past Wednesday we were given an extensive dance lesson from some of the Costa Rican Unibe students. They showed us all how to dance Salsa and Meringue with lots of different turns that made it a lot of fun. We also got to visit the National Theater and were given a tour of all the incredible artwork that is found on the walls inside. We also got the chance to go to the street market in San Jose that had dozens of venders selling all kinds of Costa Rican souvenirs. This is where many of us bought presents for those waiting back home. On Saturday, we took an all day tour that started out with some early morning zip lining. Over 12 different zip lines were included in the canopy tour. Despite the fact that a few of us were deathly afraid of heights every single person went on and completed the course, this made us all very proud. After a couple of hours zip lining and a very long bus ride we eventually got to the hot springs where we got to relax at the base of the famous Costa Rican volcanoes. It was unanimous that it was the best day of our trip so far.
During the rest of the week, we were exposed to lots of different clinical experiences as well. We were able to continue our work with the children we saw throughout the previous week and many of us even got to participate in some of the testing procedures. We also got to see some new therapeutic techniques used during the treatment of phobia. On Thursday, we got to participate in an incredibly interesting lecture on hypnosis provided by Dr. Paula Llobet. We even got to observe as she hypnotized both Brian and Dorothy as participants. Overall, it was an incredible week and we are all looking forward to the next one.

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Mental Health in Costa Rica: Week 3

Posted on August 09,2012 by latinomentalhealth

Hola from Costa Rica! This is Becca W, Valerie, and Zach checking in.

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Tagged Latino Mental Health

Week 3 Costa Rica--Escuela Miguel Obregón Lizano

Posted on August 09,2012 by latinomentalhealth

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Suave

Posted on August 09,2012 by latinomentalhealth

Agradezco mi tiempo en El Rancho. Por primera vez en mucho tiempo la he llevado suave. Estoy disfrutando el memento en Costa Rica – el idioma, la cultural, la comida, la gente, y la profesora. Cada mañana nosotros tenemos clase. A principio con otras personas, y al final solamente yo. Siento que estoy haciendo conexiones que yo no tenia antes. No solo a nivel de la estructura, sino también a nivel de las emociones y sentimientos. No me siento lista para trabajar con las personas en Español, pero pienso que puedo entenderlas. Porque escuchar es lo mas importante en la terapia, tengo esperanza de que pronto puedo trabajar con los latinos. Gracias a MSSP por enviarme (y mi profesora por su ayuda con todo esto).

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Tagged Latino Mental Health

Fundación Crecer

Posted on August 08,2012 by latinomentalhealth

Ya pasaron más de dos semanas desde que llegamos a Guayaquil, Ecuador. Han sido dos semanas en las cuales he tenido experiencias inolvidables, especialmente la experiencia de conocer a tantos niños tiernos, lindos, e inteligentes que por diversas tienen una vida que los ha forzado a crecer antes de lo debido. Durante el tiempo que estuvimos en Fundación Crecer conocimos a muchos niños, el joven más grande tiene 16 años y el más pequeño tiene 9 años. La mayoría de los niñ@s con quien hemos trabajo han tenido una vida muy difícil, la cual incluye todo tipo de violencia física, emocional, sexual, y que sucede en la casa y en la comunidad. Muchos han visto cosas que la mayoría no vamos a ver en toda una vida.

Fue un honor trabajar con [email protected] Me enseñaron bastante. A pesar de todo lo que han vivido todavía conservan su carisma, positivismo, pero sobre todo las ganas de salir adelante. Fundación Crecer hace lo que puede con los pocos recursos que tiene. Desafortunadamente, ellos no cuentan con los recursos necesarios para poder darles la ayuda que estos niños necesitan, por ejemplo no tienen exámenes psicológicos para poder evaluar a niños en áreas como emocional y de aprendizaje. Pero estoy segura que lo que Fundación Crecer hace por ellos los impacta de una manera positiva, les da esperanza y les enseña que sí existe otro mundo que no sea violencia ni maltratos, les demuestra que sí hay personas que los quieren y que quieren lo mejor para [email protected]

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Tagged Latino Mental Health

Semana Dos: Centro de Detención Juvenil

Posted on August 08,2012 by latinomentalhealth

Hola, somos Curt, Marisol, y Rebecca T. desde San José. Acabamos de terminar nuestra segunda semana de práctica. Unos de los lugares en el que hemos practicado en la semana es el Centro de Detención Juvenil. Fue muy interesante observar y notar las diferencias múltiples entre Costa Rica y los EEUU en respeto al tratamiento de los delincuentes juveniles. Por ejemplo, aprendimos que este centro es el único en Costa Rica.

Para toda la población de Costa Rica que es de 4 millones, solamente hay 210 adolescentes y adultos jóvenes encarcelados. La sentencias pueden ser máximo de quince años sin la posibilidad de libertad condicional (AKA probación). Por ejemplo, un niño de 12 años que ha recibido una sentencia de 10 años, estará encarcelado hasta los 22 años. No se ofrece servicios psicológicos ni rehabilitación aunque sea necesario. Lo que si tienen son clases de arte, baile, y deportes. La mayoría atiende la escuela dentro del centro.

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Recepción en Fundación Dra. Cynthia Lucero

Posted on August 07,2012 by latinomentalhealth

La familia Lucero ha hecho mi estancia en Guayaquil muy agradable. Yo había tenido la oportunidad de conocer a Martha y Héctor en la caminata anual que sucede en MSPP, pero ahora he tenido el honor de llegar a convivir un poco más con Martha o “Doña Martita.”

Me impresionó mucho todo lo que ella y su familia hacen en nombre de su hija, la Dra. Cynthia Lucero. Aquí en Guayaquil, la familia Lucero fundó una fundación en la cual educa y alienta a personas sobre la donación de órganos.

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Tagged Latino Mental Health

Guayaquil Welcomes MSPP Students!

Posted on August 07,2012 by latinomentalhealth

Guayaquil Welcomes MSPP Students:

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Tagged Latino Mental Health

Week 2 (mas o menos)

Posted on August 07,2012 by latinomentalhealth

This is Kelly, writing from Ecuador....

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Tagged Latino Mental Health

Costa Rica: Week Two

Posted on August 07,2012 by latinomentalhealth

Buenos dias a todos! This is Eleonora, Carla, and Oren reporting from Costa Rica.

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Tagged Latino Mental Health

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Posted on August 06,2012 by latinomentalhealth

Buenas tardes MSPP, this is John Pratico again, touching base from Guayaquil, Ecuador.

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Greetings from Ecuador! Carla here:

Posted on August 06,2012 by latinomentalhealth

This past week ended our work with the Foundation Crecer. There we met with children spanning the ages of 10 through 16. Our evaluations were based on interviews and basic psychological exams. At the end of the week, we met with the director of the Foundation Crecer and shared our observations with her. My experience from beginning to end was positive. Our group was made to feel comfortable and our knowledge was appreciated. Despite having difficult lives, the children at Crecer are as typical as any child I have ever met. I will treasure always the experience at Crecer and the warmth the staff and kids extended to us all. And because we work hard we also play hard. Our weekend trip was to Montanita, Ecuador. There the night life begins at 10:00 pm and does not end until 4:00 am. I however, am not Ecuadorian and was asleep by 12:00 am. The beaches are beautiful but do not even think about swimming. This is a surfers paradise. We are now two weeks into our immersion with only two more to go. I look forward to working at an elementary school this week. Warm wishes from Ecuador! -Carla

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Guest Faculty Post # 2: Latino Mental Health Program Immersion through Centro Ecuatoriano Norteamericano in Guayaquil, Ecuador

Posted on August 05,2012 by latinomentalhealth

Old Cathedral, Cuenca, and horse carriage

I traveled with Dr. Stacey Lambert, Director of the Latino Mental Health Program, to Guayaquil, Ecuador on Friday, July 27th and returned to the US on Tuesday, July 31st. It was a very short trip, but full of experiences that we will never forget. We arrived in Ecuador at 10 pm that Friday, and were greeted by Don Enrique and Doña Marta Lucero, Dr. Cynthia Lucero's parents, and by Don Johnny and Doña Carla Gonzalez. Johnny is the General Director of the Centro Ecuatoriano Norteamericano in Guayaquil, and he is the person who coordinates our students' experiences in their second year immersion in Ecuador.

TRIP TO CUENCA

Saturday morning we went on a car trip to Cuenca, the third largest city in Ecuador, with over half a million habitants. It is over 7,000 feet above sea level, and it takes between 3 and 4 hours of driving up a windy road through the mountains to get there.On our way, we passed through El Cajas National Park, which has beautiful views and many lakes in the mountains.

Pictures don’t make justice to the magnificent mountains and vegetation of that area. The temperature dropped considerably (hint: do not wear shorts if you are going there!). During our stay in Cuenca we visited a number of sites, including a hat factory where people make hats by hand, several churches including the old and the new cathedrals, and several markets, where we appreciated the hand made clothing and other items made by the indigenous people of the area. During the trip we were able to see differences in climate, housing, and clothing between Cuenca and Guayaquil, which is on the coast. Everyone was friendly and eager to help. We returned on Sunday afternoon to get ready for a long day on Monday.

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Tagged Forensic Psychology, Guest Blog, Clinical PsyD, Latino Mental Health, Counseling Psychology

La Segunda Semana

Posted on August 05,2012 by latinomentalhealth

This is Kiley, Lisa, and Jill reporting from Costa Rica. Another week has passed and we cannot believe that our trip is halfway over. Last weekend we traveled to Puerto Viejo on the Caribbean coast to enjoy the beaches and sun. Although, we did enjoy the beaches, we never saw the sun. Instead, we experienced downpours without electricity for periods of time. Needless to say, it was an adventure (a fun adventure)! The Caribbean coast seems a different world from San Jose, which illustrates how diverse and different Costa Rica is. We cannot wait to experience more of this incredible country.
This past week, our practicums consisted of time at the UNIBE clinic observing therapy and assessment for half the group and a day at a public school and a day at a Juvenile Facility. I will focus on the school for the majority of the blog.
The school is a primary school: kindergarten though 6th grade. The students wore uniforms and lunch was provided for each student. It was explained that students in public schools have to wear uniforms in order to lessen social and economic distinctions between students. Our day at the school was simply incredible. Each and every one of us left with a smile on our faces and a love for the children we observed. We will touch on a few high highlights from the day. When we entered the school, the first recess was beginning. The Costarricense love for soccer was evident. There were two fields in the middle of the school where the majority of the children were playing various games of soccer. We were then placed in separate classrooms to observe a normal day for the children. Each classroom was adorned with a Catholic cross and some people in our group experienced how much the church plays a role in the school. There were two events that had a major impact on me. First, a woman entered our classroom with a plastic bag which contained Colones (the Costa Rican currency), as it turns out she was collecting money for a family who lost their son a week ago. This young man was 16 years old and had attended this school for his primary education. The students in my classroom proudly donated money to this cause. Later in the afternoon, another man entered to classroom to take the children’s orders for gifts for Mothers’ Day.
The students made us feel very important. We answered their questions from, “How do you say my name in English?” to “When does this new video game come out?” We also played hopscotch and helped with schoolwork. The four hours we spent at the school were four hours none of us will forget.

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Clinical Rotations in Costa Rica, Week 2

Posted on August 01,2012 by latinomentalhealth

This is Brian and Dot reporting from the Neuropsychological Clinic at UNIBE, Costa Rica. The second week included observations of the final testing sessions of our two young children and one adolescent. Tests evaluating attention, written expression, and perceptions of self and family were utilized. The mother of one of the examinees was interviewed in order to elicit a more thorough understanding of the boy's development. As he was raised by his maternal grandmother in Guanacaste, a rural region lying northwest of San Jose, he did not have the same educational opportunities as those of his peers who grew up in the city. As a group, we are confident that the results of the psychological batteries will allow these youngsters to receive the necessary educational accommodations they so need and deserve. In addition to observing the administration of the final psychological batteries, we observed two therapy sessions conducted by a clinical psychologist in which she employed REBT (Rational Emotive Behavioral Therapy) with a young male and young female, both in their early twenties. Similar to CBT, in which the therapist examines the interaction between thoughts, feelings and behaviors, it was refreshing to see a more pro-active approach used in the first session, where the focus of the interview was on the clients' presenting problem and their perception of it, not so much on biographical information. The male client presented with anxiety regarding the distancing of his girlfriend and his disillusionment in the lack of affection he was receiving. The female client, also presenting with relationship difficulties, more specifically dealing with depression, reported recent suicidal ideation. The therapist used REBT to challenge some of her irrational beliefs and provided the client with psychoeducation regarding the benefit of psychopharmaceuticals.

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Puerto Viejo, Costa Rica

Posted on August 01,2012 by latinomentalhealth

This is Elena, Brian, and Dot writing from Puerto Viejo, a small surfing town on the Caribbean coast in the region of Limón. After a fruitful and engaging week at practicum and class, this day trip provided the group with both a chance to unwind as well as a rich cultural experience. The journey to Puerto Viejo proved adventurous, what with hairpin turns and steep, rainy mountain passes, but it was well worth it! Though the trip was short-lived, we were able to get a feel for local culture, which included a diverse population of local residents and people living abroad.

Rain-filled skies did not put a damper on our adventure: some of us had the opportunity to take a morning surf lesson before leaving (in Spanish!), while others swam in the warm Caribbean and partook in Latin and Reggae dancing. Road-side stops on the way and coming back from Puerto Viejo allowed us to experience local cuisine and small-town culture outside of the city of San José. Some of the food at a road-side kitchen included huevos mexicanos, gallo pinto (a staple!), and carne con jamón. We are really looking forward to our trip to the Arenal volcano and Baldi hot springs this weekend which will include zip lining through the lush jungles!

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