POPULATION
The July 1989
census recorded a population of 2.92 million, more than half of whom live in the
Central Valley. Approximately 275,000 live in the capital city of San
José. Fifty-one percent of the nation's population is classed as urban.
The country's annual population growth rate is currently 2.3% and gradually
falling. As recently as the 1960s the rate was a staggering 3.8% per annum, a
figure no other country in the world could then match. The impressive decline in
recent decades has likewise been matched by few other countries.
All the municipalities of the Meseta Central have gained agricultural migrants
for whom there is simply no more room. Hence, emigration from the Meseta Central
in recent decades has taken people in all directions, assisted by government
incentives. The most attractive areas of settlement in the past 35 years have
been on the Nicoya lowlands on the drier part of the Pacific coast, on the
northern lowlands, and on the alluvial soils of the Valle de El General in the
south. The Pan-American Highway has attracted settlers, and the border between
Panama and Costa Rica is now quite densely settled, with colonists from Italy as
well as the Meseta Central grafted onto the local population.
CLASS AND RACE
Most Costa Ricans insist that their country is a "classless democracy." True,
the social tensions of class versus class that characterize many neighboring
nations are absent. Ticos lack the volatility, ultranationalism, and deep-seated
political divisions of their Latin American brethren. There is considerable
social mobility, and no race problem on the scale of the United States'. And
virtually everyone shares a so-called middle-class mentality, a firm belief in
the Costa Rican equivalent of "the American Dream"--a conviction that through
individual effort and sacrifice and a faith in schooling every Costa Rican can
climb the social ladder and better him- or herself.
Still, despite
the high value Ticos place on equality and democracy, their society contains all
kinds of inequities. Wealth is unevenly distributed (the richest one percent of
families receive 10% of the national income; the poorest 50% receive only 20%;
and at least one-fifth of the population remain marginados who are so poor
they remain outside the mainstream of progress).
A small number of families--the descendants of the original hidalgos
(nobles)--have monopolized power for almost four centuries (just three families
have produced 36 of Costa Rica's 49 presidents, and fully three-quarters of
congressmen 1821-1970 were the offspring of this "dynasty of
conquistadores").
Urbanites, like city dwellers worldwide, condescendingly chuckle at rural
"hicks." The skewed tenure of an albeit much-diluted feudalism persists in
regions long dominated by plantations and haciendas. The upwardly mobile consider
menial labor demeaning. And tolerance of racial minorities is tenuous, with
"whiteness" still considered the ideal.
Though comparatively wealthy compared to most Latin American countries, by
developed-world standards most Costa Ricans are poor (the average income is
slightly less than US$3000 per annum). Many rural families still live in simple
huts of adobe or wood; the average income in the northern lowlands, for example,
is barely one-seventh that in San José. And although few and far between,
shacks made from gasoline tins, old automobile tires, and corrugated tin give a
miserable cover to poor urban laborers in small tugurios--illegally
erected slums--on the outskirts and the riverbanks of San José.
However, that all paints far too gloomy a picture. In a region where thousands
thrive and millions starve, the vast majority of Costa Ricans are comparatively
well-to-do. The country has few desperately poor, and there are very few beggars
existing on the bare charity of the world. The majority of Costa Ricans keep
their proud little bungalows spick and span and bordered by flowers, and even the
poorest Costa Ricans are generally well groomed and neatly, even formally,
dressed: the men in fedoras, the women in shawls.
Overt class distinctions are kept within bounds by a delicate balance between
"elitism" and egalitarianism unique in the isthmus: aristocratic airs are frowned
on and blatant pride in blue blood is ridiculed; even the president is inclined
to mingle in public in casual clothing and is commonly addressed in general
conversation by his first name or nickname.
Costa Rican Ethnicity
Costa Rica is unquestionably the most homogeneous of Central American nations
in race as well as social class. Travelers familiar with other Central American
nations will immediately notice the contrast: the vast majority of Costa Ricans
look predominantly European. The 1989 census classified 98% of the population as
"white" or "mestizo," and less than two percent as "black" or "Indian." Native
and European mixed blood far less than in other New World countries. There are
mestizos--in fact, approximately 95% of Ticans inherit varying mixtures of the
mestizo blend of European colonists with Indian and black women--but the lighter
complexion of Old World immigrants is evident throughout the nation. Exceptions
are Guanacaste, where almost half the population is visibly mestizo, a legacy of
the more pervasive unions between Spanish colonists and Chorotega Indians through
several generations. And the population of the Atlantic coast province of Puerto
Limón is one-third black, with a distinct culture that reflects its West
Indian origins.
Blacks
Costa Rica's
approximately 40,000 black people are the nation's largest minority. For many
years they were the target of racist immigration and residence laws that
restricted them to the Caribbean coast (only as late as 1949, when the new
Constitution abrogated apartheid on the Atlantic Railroad, were blacks allowed to
travel beyond Siquerres and enter the highlands). Hence, they remained isolated
from national culture. Although Afro-Caribbean turtle hunters settled on the
Caribbean coast as early as 1825, most blacks today trace their ancestry back to
the 10,000 or so Jamaicans hired by Minor Keith to build the Atlantic Railroad,
and to later waves of immigrants who came to work the banana plantations in the
late 19th century.
Costa Rica's early black population was "dramatically upwardly mobile" and by
the 1920s a majority of the West Indian immigrants owned plots of land or had
risen to higher-paying positions within the banana industry. Unfortunately, they
possessed neither citizenship nor the legal right to own land. In the 1930s, when
"white" highlanders began pouring into the lowlands, blacks were quickly
dispossessed of land and the best-paying jobs. Late that decade, when the banana
blight forced the banana companies to abandon their Caribbean plantations and
move to the Pacific, "white" Ticos successfully lobbied for laws forbidding the
employment of gente de color in other provinces, one of several
circumstances that kept blacks dependent on the largesse of the United Fruit
Company, whose labor policies were often abhorrent. Pauperized, many blacks
migrated to Panama and the U.S. seeking wartime employment. A good proportion of
those who remained converted their subsistence plots into commercial cacao farms
and reaped large profits during the 1950s to '60s from the rise of world cacao
prices.
West Indian immigrants played a substantial role in the early years of labor
organization, and their early strikes were often violently suppressed (Tican
folklore falsely believes in black passivity). Many black workers, too, joined
hands with Figueres in the 1948 Civil War. Their reward? Citizenship and full
guarantees under the 1949 Constitution, which ended apartheid.
Costa Rica's black population has consistently attained higher educational
standards than the national average and many blacks are now found in leading
professions throughout the nation. They have also managed to retain much of their
traditional culture, including religious practices rooted in African belief about
transcendence through spiritual possession (obeah), their rich cuisine
(codfish and akee, "rundown"), the rhythmic lilt of their slightly antiquated
English, and the deeply syncopated funk of their music.
Indians
Costa Rica's indigenous peoples have suffered abysmally. Centuries ago the
original Indian tribes were splintered by Spanish conquistadores and compelled to
retreat into the vast tracts of the interior mountains (the Chorotegas of
Guanacaste, however, were more gradually assimilated into the national culture).
Today, approximately 9,000 Indian peoples of the Bribrí, Boruca, and
Cabecar tribes manage to eke out a living from the jungles of remote valleys in
the Talamanca Mountains of southern Costa Rica, where their ancestors had sought
refuge from Spanish muskets and dogs. There are currently 22 Indian reserves for
eight different Indian groups.
Although various agencies continue to work to promote education, health, and
community development, the Indians' standard of living is appallingly low,
alcoholism is endemic, and they remain subject to constant exploitation. In 1939,
the government granted every Indian family an allotment of 148 hectares for
traditional farming, and in December 1977 a law was passed prohibiting
non-Indians from buying, leasing, or renting land within the reserves.
Despite the legislation, a majority of Indians have gradually been tricked
into selling their allotments or otherwise forced off their lands. Poor soils and
rough rides have not kept colonists in search of land and gold from invading the
reserves. Banana companies have gradually encroached into the Indian's remote
kingdoms, buying up land and pushing campesinos onto Indian property. Mining
companies are infiltrating the reserves along newly built roads which become
conduits for contamination, like dirty threads in a wound. In 1991, for example,
an American mining company was accused of illegally exploring within the
Talamanca Indian Reserve. And hotel developers are violating the protective laws
by pushing up properties within coastal reserves.
Indigenous peoples complain that the National Commission for Indigenous
Affairs (CONAI) has proved particularly ineffective in enforcing protections.
"When the moment arrives for CONAI to stand up for the Indian people, they don't
dare. They duck down behind their desks and wait for their paychecks to arrive,"
says Boruca Indian leader José Carlos Morales.
The various Indian clans cling tenuously to what remains of their cultures.
The Borucas, who inhabit scattered villages in tight-knit patches of the Pacific
southwest, have been most adept at conserving their own language and
civilization, including matriarchy, communal land ownership, and traditional
weaving. For most other groups, only a few elders still speak the languages, and
interest in traditional crafts is fading. Virtually all groups have adopted
elements of Catholicism along with their traditional animistic religions, Spanish
is today the predominant tongue, and economically the Indians have for the most
part come to resemble impoverished campesinos.
Other Ethnic Groups
Immigrants from many nations have been made welcome over the years (between
1870 and 1920, almost 25% of Costa Rica's population growth was due to
immigration). Jews are prominent in the liberal professions. There is a Quaker
community of several hundred people centered on Monteverde, where they produce
goudas, cheddars, and monterico cheeses. Germans have for many generations
been particularly successful as coffee farmers. Italians have gathered, among
other places, in the town of San Vito, on the central Pacific coast. Tens of
thousands of Central American refugees from El Salvador, Guatemala, and Nicaragua
still find safety in Costa Rica, where they provide cheap labor for the coffee
fields. The Chinese man quoted in Paul Theroux's Old Patagonia Express
(see p. xiii) is one of several thousand Chinese who call Costa Rica home. Many
are descended from approximately 600 Orientals who were imported as contract
laborers to work on the Atlantic Railroad (an 1862 law prohibiting immigration by
Asians had been lifted on the understanding that the Chinese would return home
once the work was complete). The Chinese railroad workers were worked miserably
and paid only one-fifth of the going wage. In recent years many chinos
have immigrated freely and are now conspicuously successful in the hotel,
restaurant, and bar trade (Theroux's Chinese man owned one of each), and in
Limón as middlemen controlling the trade in bananas and cacao.
THE TICAN IDENTITY
Every nationality has its own sense of identity. Costa Ricans have
their own unique traits that derive from a profoundly conscious self-image
which orients much of their behavior as both individuals and as a nation. The
Ticos--the name is said to stem from the colonial saying "we are all
hermaniticos (little brothers)"--feel distinct from their neighbors by
their "whiteness" and relative lack of indigenous culture. Ticos identify
themselves first and foremost as Costa Ricans and only Central Americans, or even
Latin Americans, as an afterthought.
They're extremely critical of themselves, as individuals and as a
society. Costa Ricans, too, regardless of wealth or status, act with utmost
humility and judge as uncouth boasting of any kind. Their behavior and comments
are dictated by quedar bien, a desire to leave a good impression. Like the
English, they're terribly frightened of embarrassing themselves, of appearing
rude or vulgar (tactless and crude people are considered "badly educated") or
unhelpful. As such, they are exceedingly courteous, almost archaically so (they
are prone, for example, to offer flowing compliments and formal greetings). It is
a rare visitor to the country who returns home unimpressed by the Costa Ricans'
celebrated cordial warmth and hospitality.
Ticos are also as tranquil as doves. Violence of any kind is extremely rare.
The religious fervor common in Mexico and the Central American isthmus is
unknown. And the law-abiding Ticos respect and have faith in their laws, their
police force, and state institutions (except, it seems, on the roads). In fact, a
distaste for anything that impinges on their liberty or that of their nation is
just about the only thing that will make their hackles rise. Attempts to
modernize the police force, for example, bring floods of editorial columns and
popular outrage protesting "militarism."
Democracy is their most treasured institution, and the ideal of personal
liberty is strongly cherished. Costa Ricans are intensely proud of their
accomplishments in this arena and show it at 6 p.m. on each 14 September, on the
eve of Independence Day, when the whole nation comes to a halt and everyone
gustily sings the national anthem.
A progressive people, Ticos revere education. "We have more teachers than
soldiers" is a common boast and framed school diplomas hang in even the most
humble homes. Everyone, too, is eager for the benefits of social progress.
Sociologists, however, suggest that Costa Ricans are very conservative people,
suspicious of experimentation that is not consistent with a loosely held sense of
"tican tradition." Changes, too, supposedly should be made poco a
poco, little by little. Ticos share the fatalistic streak common to Latin
America: one that accepts things as they are and promotes resignation to the
imagined will of God.
Many old virtues and values have faltered under the onslaught of foreign
influence, modernity, and social change. Drunkenness, drug abuse, and a general
idleness previously unknown in Costa Rica have reared their ugly heads. And theft
and burglary are seriously on the rise (see "Safety," p. 162). But most Costa
Ricans remain strongly oriented around traditional values based on respect for
oneself and for others. The cornerstone of society is still the family and the
village community. Social life still centers on the home and family bonds are so
strong that foreigners often find making intimate friendships a challenge.
Nepotism--using family ties and connections for gain--is the way things get done
in business and government.
You can count on a Tico's loyalty, but not on his punctuality. Private
companies, including most travel businesses, are efficient and to a greater or
lesser degree operate hora americana: punctually. But don't expect it.
Many Ticos, particularly in government institutions, still tick along on
turtle-paced hora tica. "[[questiondown]]Quien sabe?" ("Who
knows?") is an oft-repeated phrase. So too "[[exclamdown]]Tal vez!"
("Perhaps!") and, of course, "[[exclamdown]]Mañana!"
("Tomorrow!").
SEX, MACHISMO,
AND THE STATUS OF WOMEN
In October 1990 I had dinner in San José with a young North American
friend who was studying for a year at the University of Costa Rica. She is tall,
beautiful, with hair as blonde as flax (to Tico men, the erotic equivalent of a
red rag to a bull) and skin as white as fresh-fallen snow. She was tired, she
told me. Tired of the attention-arresting "Ssssst!" of the Tico male. Tired of
the silent, insistent stares--of dando cuerva, "making eyes." Tired of
leeringly being called guapa, mi amor, and
[[exclamdown]]machita! To her, Costa Rica was a land of unbridled and ugly
machismo.
Everything in life of course is relative. Yes, Tico men make a national
pastime of flirting. But by the standards of other Latin American countries--I am
constantly assured--Costa Rican men are relatively restrained in their advances,
and the nation progressive and moderately successful in advancing the equal
rights of women.
That said, legacies of the Spanish Catholic sense of "proper" gender roles are
twined like tangled threads through the national fabric. Male and female roles
are clearly defined. Machismo, sustained by a belief in the natural superiority
of men, is integral to the Costa Rican male's way of life. It "justifies" why he
expects to be given due deference by women, why he expects his wife or
novia (girlfriend) to wait on him hand and foot, why he refrains from
household chores, and why he is generally free to do as he pleases, particularly
to sleep around. The sexual wanderings of married men are still tolerated by a
remarkably high percentage of women; and the faithful husband and male celibate
is suspect in the eyes of his friends. The Latin male expresses his masculinity
in amorous conquests. In Costa Rica flirting has been taken to the level of art.
"Making love is the number one pastime in Costa Rica, followed by drinking and
eating," suggests writer Kent Britt. "Futbol (soccer), the so-called
national sport, isn't even in the running."
But it always takes
two to tango. San José's stylish young Ticas, with their unbelievably
tight jeans and high heels, give as good as they get. Hip urban Ticas have
forsaken old-fashioned romanticism for a latter-day liberalism that accepts
short-term relationships and sexual pleasure. Even in the most isolated rural
towns, dating in the Western fashion has displaced the retreta--the
circling of the central plaza by men and women on weekend evenings--and
chaperonage, once common, is now virtually unknown.
The rules of the mating game, however, are not the same as in Europe or North
America. A gradual wooing is expected. Males are expected to adhere to
traditional romantic roles; Sir Walter Raleigh would do well here with his cloak.
And females can be both outrageously flirtatious and stand-offish as part of the
ritual.
Costa Ricans are liberal in their sexual relations, even if some of the mental
projections don't quite match up. Women are supposed to be loyal and
chaste. Sexual freedom is the prerogative of males; sexually liberated women are
still looked down on as "loose." You don't need to be Einstein to work out the
mathematical inconsistencies and mental delusions this implies. In fact, almost
10% of all Costa Rican adults live together in "free unions," one-quarter of all
children are hijos naturales (born out of wedlock; one in five of such
births list the father as "unknown"), and one in five households is headed by a
single mother. Many rural households are so-called Queen-bee (all-female)
families headed by an elderly matriarch who looks after her grandchildren while
the daughters work. Divorce, once a stigma, is now common and easily obtained
under the Family Code of 1974, although desertion remains as it has for centuries
"the poor man's divorce."
Compañeras, women in consensual relationships, enjoy the same
legal rights as wives. In theory, the law, too, forbids sex discrimination in
hiring and salaries, and women are entitled to maternity leave and related
benefits. And urban women have attained considerable success in the political and
professional arena: women outnumber men in many occupations and notably in
university faculties, the nation's vice-president 1986-90 was a woman (Dr.
Victoria Garron), and the current president of the National Assembly is Dr.
Rosemary Karpinsky. The 1990 Law to Promote Women's Social Equality should
provide one more stepping-stone to real equality.
In reality, discrimination is ingrained. Low-level occupations especially
reflect wide discrepancies in wage levels for men and women. The greater
percentage of lower-class women remain chained to the kitchen sink and the
rearing of children. And gender relationships, particularly in rural villages,
remain dominated to a greater or lesser degree by machismo and marianismo,
its female equivalent. Women are supposed to be bastions of moral and spiritual
integrity (to call a wife and mother abnegado--self-sacrificing--is the
ultimate compliment), to be accepting of men's infidelities, and to "accept
bitter pride in their suffering."
RELIGION
Costa Ricans are said to be "lukewarm" when it comes to religion. Although
more than 90% of the population is Roman Catholic, at least in name, almost no
one gets riled up about their faith. Sure, Holy Week (the week before Easter) is
a national holiday, but it's simply an excuse for a secular binge. The passing of
the parish priest inspires no reverential gestures. And most Costa Ricans respond
to the bell, the public voice of the church, only on special occasions, generally
when the bell peals for birth, marriage, and maybe for Easter Morning, when the
mass of men mill by the door, unpiously half in and half out.
The country has always been remarkably secular, the link between Christianity
and the state--between God and Caesar--always weak. The Costa Ricans' dislike for
dictators has made them intolerant of priests. The feudal peasants of other
Central American nations, miserably toiling on large estates (latifundias)
or their own tiny plots, may have been poor and ignorant, but the Church offered
them one great consolation. Theirs would be the kingdom of heaven. And in more
recent times, when Catholic organizations attempted to address pressing social
problems, they strengthened the Church's bond with the people. In Costa Rica, by
contrast, the Church, from the earliest colonial times, had little success at
controlling the morals and minds of the masses. While poor peasants can be
convinced they'll become bourgeois in heaven, a rising class wants its comforts
on earth. Costa Rica's modernity and "middle-class" achievements have made the
Church superfluous.
Still, every
village no matter how small has a church and its own saint's day, albeit
celebrated with secular fervor. Every taxi, bus, government office, and home has
its token religious icons. The Catholic marriage ceremony is the only church
marriage granted state recognition. And Catholicism is the offical state
religion. The 1949 Constitution even provided for state contributions to the
maintenance of the Church; and the salaries of bishops are paid by the state.
Catholicism, nonetheless, has only a tenuous hold; mass in some rural
communities may be a once-a-year affair, and resignation to God's will is tinged
with pagan fatalism. In a crisis Ticos will turn to a favorite saint, one who
they believe has special powers or "pull" with God, to demand a miracle. And
folkloric belief in witchcraft is still common (Escazú is renowned as a
center for brujos, witches who specialize in casting out spells and
resolving love problems).
Protestantism has proved even less spellbinding. The Catholic clergy has
fiercely protected its turf against Protestant missionaries (even Billy Graham's
tour in 1958 was blackballed by the local media), and the Protestant evangelism
so prevalent in other parts of Central America has yet to make a dent in Costa
Rica. A great many sects, however, have found San José the ideal base for
proselytizing forays elsewhere in the isthmus. The nation's black population
constitutes about half of Costa Rica's 40,000 or so Protestants, though the
archbishop of Canterbury would be horrified at the extent to which "his" religion
has been married with African-inspired, voodoo-like obeah and
pocomoia cult worship.
EDUCATION
The briefest sojourn in San José makes clear that Costa Ricans are a
highly literate people: the country boasts of 93% literacy in those 10 and over,
the most literate populace in Central America. Many of the country's early father
figures, including the first president, José Maria Castro, were former
teachers and shared a great concern for education. In 1869, the country became
one of the first in the world to make education both obligatory and free, funded
by the state's share of the great coffee wealth (as early as 1828, an unenforced
law had made school attendance mandatory). Then, only one in 10 Costa Ricans
could read and write. By 1920, 50% of the population were literate. By 1973, when
the Ministry of Education published a landmark study, the figure was 89%.
The study also revealed some worrying factors. Over half of all Costa Ricans
aged 15 or over--600,000--had dropped out of school by the sixth grade, for
example. Almost 1,000 schools had only one teacher, often a partially trained
aspirante (candidate teacher) lacking certification. And the literacy
figures included many "functional illiterates" counted by their simple ability to
sign their own name. The myth of "more teachers than soldiers" and the boast of
the highest literacy rate in Central America had blinded Costa Ricans to their
system's many defects.
The last 20 years have seen a significant boost to educational standards.
Since the 1970s the country has invested more than 28% of the national budget on
primary and secondary education. A nuclearization program has worked to
amalgamate one-teacher schools. And schooling through the ninth year (age 14) is
now compulsory. Nonetheless, there remains a severe shortage of teachers with a
sound knowledge of the full panoply of academic subjects, discredited
rote-learning methods are still common, remote rural schools are often difficult
to reach in the best of weather, and the Ministry of Education is riven with
political appointees who change hats with each administration. As elsewhere in
the world, well-to-do families usually send their children to private
schools.
Village libraries are about the only means for adults in rural areas to
continue education beyond sixth grade. The country, with approximately 100
libraries, has a desparate need for books and for funds to support the hundreds
of additional libraries which the country needs. Books (Spanish preferred) can be
donated to the National Library (c/o Vera Violeta Salazar Mora, Director,
Dirección Bibliotecas Públicas, Apdo. 10-008, San José; tel.
236-1828).
A new program recently instigated by the Ministerio de Educatión
accepts volunteers to teach English (Departamento de Inglés, San
José 1000). WorldTeach (Harvard Institute for International
Development, 1 Eliot St., Cambridge, MA 02138; tel. 617-495-5527, fax
617-495-1239) also places volunteers to teach English in schools that have
requested assistance. The local school or community provides housing and a living
allowance; you pay a participation fee of $3500 that covers airfare, health
insurance, training, and field support.
Universities
Although the country lacked a university until 1940, Costa Rica now boasts
four state-funded schools of higher learning, and opportunities abound for adults
to earn the primary or secondary diplomas they failed to gain as children.
The University of Costa Rica (UCR), the largest and oldest university,
enrolls some 35,000 students, mostly on scholarships. The main campus is in the
northeastern San José community of San Pedro (UCR also has regional
centers in Alajuela, Turrialba, Puntarenas, and Cartago). The National
University in Heredia (there are regional centers in Liberia and Perez
Zeledon) offers a variety of liberal arts, sciences, and professional studies to
13,000 students. Cartago's Technical Institute of Costa Rica (ITCR)
specializes in science and technology and seeks to train people for agriculture,
industry, and mining. And the State Correspondence University, founded in
1978, is modeled after the United Kingdom's Open University and has 32 regional
centers offering 15 degree courses in health, education, business administration,
and the liberal arts.
In addition, there are many private institutions, including the Autonomous
University of Central America and the University for Peace, sponsored
by the United Nations and offering a master's degree in Communications for
Peace.
HEALTH
Perhaps the most impressive impact of Costa Rica's modern welfare state has
been the truly dramatic improvements in national health. Infant mortality has
plummeted from 25.6% in 1920 to only 1.5% in 1990. The annual death rate dropped
from 41 per thousand in 1894 to 18 in 1944 and just 3.9 per thousand in 1989. And
the average Costa Rican today can expect to live to be a ripe 73.2 years
old--longer than the average U.S.-born citizen. All this thanks to the Social
Security system which provides universal insurance benefits covering medical
services, disability, maternity, old-age pensions, and death.
Currently Costa Rica assigns about 10% of its GNP to health care. The result?
A physician for every 700 people and a hospital bed for every 275. In fact, in
some areas the health-care system isn't far behind that of the U.S. in terms of
the latest medical technology, at least in San José, where transplant
surgery is now performed. Many Americans fly in for surgery, including dental
work, here. And the Beverly Hills crowd helps keep Costa Rica's cosmetic surgeons
busy.
One key to the nation's success was the creation of the Program for Rural
Health in 1970 to ensure that basic health care would reach the furthest
backwaters. The program, aimed at the 50% of the population living in small
communities, established rural health posts attended by paramedics. The clinics
are visited regularly by doctors and nurses, and strengthened by education
programs stressing good nutrition, hygiene, and safe food preparation. Even a few
years ago malnutrition reaped young Ticos like a scythe; in the last two decades
infant mortality due to malnutrition has fallen by over 80%. In April 1992, the
Social Security service initiated a new plan aimed at lowering infant mortality
to one percent. It's a constant battle, however. Health standards slipped
slightly in 1990-91 due to budget cutbacks: the tuberculosis rate doubled in
1991, for example, and that year the nation witnessed its first measles epidemic
in many years. But then again, so did the United States.