The FIMRC clinic Projecto de San Felipe is nestled along a major road through the barrio of Alajuelita some 20 minutes outside of San José, Costa Rica. The barrio is made up of mostly Nicaraguan immigrants, undocumented. Alajuela is a department of Costa Rica that borders Nicaragua, a region that serves as a funnel of immigrants towards the capital city.
The official population of Alajuelita is unknown. Probably there are close to 100,000 maybe more. The movement of people in and out of the barrio and the birth of children set the population in a constant state of flux. Houses are squatter houses made of concrete cement blocks and rusted corrugated tin roofing. Many of the houses have one or two rooms, maybe three with a bathroom. The floors are mostly concrete but many of the most poor are dirt. The home will house anywhere from 4 – 20 people per habitation, usually made up of families with multiple fathers, aunts and uncles. The parents work as domestic servants and in trade, leaving the children at home to fend for themselves, often in the care of some extended family member. There is a higher number of children over the age of 7 years old as opposed to toddlers. Younger children between the age of 1 year and 6 years old have returned to Nicaragua to live with a grandparent. The idea is that the child will return to Costa Rica with their passport at the age of 6 or 7 to enter into school.
Education in Costa Rica is free to Costa Ricans. This includes the cost of books and uniforms. The common rhetoric by Costa Ricans as to why Nicaraguans come to Costa Rica is so their children (born in Nicaragua) can enter into school free. We can assume then that mothers deliver their children to school. The evidence of this is that many of the adolescents who come into Tatiana’s care (the psychologist at FIRMC) have come from her encounters with them at school.
The lived experience of both children and adults in the Costa Rican slum is difficult. This Costa Rican barrio is akin to a Brazilian favela. None of the inhabitants own the property they live in or on, the neighborhoods are very dangerous, police will not enter into the area much, and taxis will absolutely not enter into the area at night. Despite these comparisons, there are differences. La Alajuelita has state services and schools in the area and it is not an internalized entity. There are, however, no health services other than the FIMRC clinic.
The FIMRC clinic is run by local, impassioned Costa Ricans – a doctor, a psychologist, and a law student. Having Costa Ricans who have great sympathy for these people IS why the clinic is so successful and trusted by the population. Clients report that their experiences in the Costa Rica public health clinics are unsatisfactory. The clinics have too many patients and do not offer enough attention to the ailments of the children and many are dismissed without diagnosis or medicines. The marginalized become more marginalized.
Children in La Alajuelita suffer from many conditions both physical ailments and mental issues. Common diseases are preventable and easily treatable – skin rashes, upper respiratory infections, strep, influenza, and sinus problems. Parasites is their largest issues. Houses sit very close to one another an their sewage runs into neighbors homes, therefore parasites are their most common problem. FIMRC is an global health program dedicated to teaching preventative health care through education. All FIMRC clinics strive to not only treat preventable diseases but also educate the population on safe health habits. Each clinic has public health campaigns run by volunteers that teach everything from hand washing to dental care to water purification and first line defense to prevent infection. These populations are all very poor with little education. It is a mistake to take for granted that people know healthy habits or have access to materials as simple as a clean toothbrush or toothpaste.