An informal village called La Carpio is located about 10 kilometers from the downtown of San José, Costa Rica. Due to its separation from the neighboring areas and its bordering Virilla and Torres rivers, it is rather isolated. As a result, its reputation is one of the most marginalized towns in the nation. Early in the 1990s, as waves of Nicaraguan refugees left the political and economic unrest in their homeland, La Carpio was founded. Many of the inhabitants still lack legal status, which restricts their ability to obtain official jobs, access quality healthcare, education, and government assistance. Over the years, tens of thousands of people, mostly of Nicaraguan descent, have moved into the settlement.
The purpose of the visit to La Carpio was to cooperate with the local clinic and set up a health promoter to address the health disparities within the community. The students had set up 6 stations: weight, blood pressure, glucose and cholesterol, glasses, dental, and CPR training for adults and children. It was within expectations that around 50 patients would come in, but by the end the health promoter, approximately 100 patients attended, twice the expected amount. Fellows Nouhad Khoury, Jessica Haddad, Rachel Vemula, Veronica Wheatley, Ean Hudak, and Valentyn Sukhhy reflected on their first time volunteering at the Health Promoter held in La Carpio during the winter break.
Nouhad Khoury (Biology, ‘26)
After taking the Just Healthcare and Developing Nation class offered at Saint Joseph’s, my class and I had the chance to visit Costa Rica for seven days. The purpose of our trip was to learn about the country’s culture, history, health care system, and related facilities. On the fourth day of our trip, we visited La Carpio, a vibrant community with a majority migrant population, most of whom were Nicaraguan. We started at a local clinic, where the staff shared a surprising reality for many in La Carpio. Although Costa Rica proclaims universal healthcare for all, I learned that there are rules and exceptions to this. For many undocumented residents or those with a limiting income, accessing medical care is a serious challenge. The clinic there had enough resources to provide initial care. However, for some more serious or debilitating conditions, community members are forced to pay hefty costs or find ways to live with their burdens. To promote the health promoter we were planning to set up, our class was divided into groups and assigned two members from the nearby church’s youth group to accompany us around La Carpio. The two young guides in my group were born and raised in La Carpio and provided us with valuable insight into the lives of the people there. With their help, we passed out flyers, chatting with the residents and promoting the event.
The initial expectation for the health promoter was around 50 attendees, but soon enough twice the amount of people showed up. I recognized some of them from earlier, but now they had brought their family and friends as well. The room became a center of activity, with practically all of the seats filled within the first hour of starting. My role as a coordinator allowed me to move between tables and assist when needed. Through this, I spoke with many of the patients and listened to their stories. People shared not just their health concerns but also their struggles and triumphs. It was truly inspiring to see the resilience of the individuals we served in face of their challenges, and it was an honor to be part of a team dedicated to improving health outcomes in the community.
This experience wasn’t just about providing healthcare, it was about building connections. In our class, we emphasize the importance of cultural humility: listening, learning, and meeting people where they are. Visiting Costa Rica and immersing ourselves in the daily lives and culture of its people gave me a deeper understanding of their challenges and experiences. My time in La Carpio reaffirmed that good healthcare goes beyond treating illness—it’s about seeing the whole person: their culture, their struggles, and their aspirations. Strengthening my belief that healthcare is a shared journey of mutual respect, understanding, and growth rather than a service we simply offer.
Jessica Haddad (Biology, ‘26)
This past week, I had the opportunity to volunteer in La Carpio, a prospering but neglected village in Costa Rica, where I worked together with my classmates to address the community members’ healthcare needs. The village, largely home to Nicaraguan immigrants, was near the city yet felt separated due to the hardships its residents faced. Many families in La Carpio lacked access to basic necessities such as clean water and regular medical treatment, making them vulnerable to preventable medical and dental conditions. When I was inviting residents to the free clinic we were hosting, there was a moment that really touched me. A man instinctively covered his mouth when I mentioned the clinic, a clear sign of self-consciousness about his teeth. He was embarrassed by the condition of his teeth, and it was devastating to see the extent of his subtle yet obvious distress.
I realized then that dental health was not only an oral health issue for him and many others in La Carpio, but also an emotional one that was connected to self-worth and dignity. In an attempt to help, I reassured him that the clinic was a judgment-free environment with the help of translators and completely free of charge. I made sure he was comfortable and treated with respect during his visit. One of my favorite parts of my stay there was watching him go to each station with relief and offering him a little bag of dental supplies. This experience made me realize that healthcare is about more than just curing physical problems. Treating people is also about bringing about hope and confidence. This man made me more committed to advocating for everyone to have access to humane, compassionate treatment, especially those who do not consider themselves deserving or face socioeconomic challenges. This experience resonates with my broader vision as a future dental professional: to develop a model of care that addresses and eliminates barriers to oral healthcare for underserved populations.
Rachel Vemula (Biology, ‘27)
This past week, I had the rare opportunity to visit Costa Rica and engage firsthand with its healthcare system. Costa Rica is renowned for its universal healthcare, which promises comprehensive, cost-free care for all citizens. However, my visit to La Carpio, a marginalized community outside San José, revealed the stark contrast between the system’s ideals and the reality of vulnerable populations. Nestled near a landfill and flanked by polluted rivers, La Carpio’s residents endure unsafe living conditions and limited access to healthcare despite their hard work and resilience. Offering basic medical services to residents, our group ran a health promoter in La Carpio for the first time. The clinic quickly became a hub of activity with high demand, causing dental and cholesterol supplies to run out an hour before the event was set to end. While volunteering, we addressed prevalent issues such as diabetes, anemia, and respiratory illnesses. One moment that stood out was when Ean and Father Clark helped a man with a wrist injury, providing him with a brace. Unable to afford follow-up care after his cast fell off, he had gone without proper treatment. His situation highlighted the systemic gaps that leave many without adequate care.
Another impactful interaction was with a mother whose young son had experienced seizures and respiratory issues earlier that morning. Desperate for help, she brought him to our free clinic after hearing about it. While taking his glucose reading, she shared her own struggles with diabetes, explaining that she could only monitor her condition sporadically due to limited access. Her vulnerability and strength were humbling, serving as a powerful reminder of the unseen challenges many endure. This experience underscored the reality that even in systems designed for equity, communities like La Carpio often fall through the cracks. Running the health promoter reminded me of the importance of truly listening to people and understanding their struggles beyond what’s visible. It reaffirmed my commitment to serving underserved populations and working to bridge gaps in access to care. The resilience of La Carpio and its residents inspire me to advocate for more equitable healthcare and to continue serving those most in need.
Veronica Wheatley (Biology, ‘25)
As I returned from a once in a lifetime experience in Costa Rica, I want to reflect on one particular day that stood out as a truly moving experience. During our time there, we set up a free health clinic in La Carpio, a marginalized community home to many Nicaraguan refugees. At the clinic, I was working at the reading glasses station, one of my favorite stations. It is a station that usually doesn’t draw much attention back home, but here, it was a completely different story. I carefully organized the glasses by prescription, ranging from +1 to +3.5, and waited for patients to arrive. Before long, the clinic grew busy, and to my surprise, my station quickly became one of the most popular.
One patient, in particular, left a lasting impression on me. He was a Nicaraguan refugee, who had fled his country due to political instability and violence. He shared with me how he had been beaten by the Nicaraguan military, either for opposing their regime or for attempting to escape. As he told me his story, he even showed me photos of the aftermath–his eyes swollen and bruised beyond recognition. The beating had been so severe that it appeared his retina might have been detached. Despite all this, he was incredibly grateful for the simple act of providing reading glasses. I felt a profound warmth in being able to help someone who had endured so much. Though I could only offer him a small measure of aid, his gratitude spoke volumes. It was a humbling reminder of how even the smallest actions can make a meaningful difference in the lives of those who are most vulnerable. Hearing people’s stories and seeing their humanity beyond just a number is what truly mattered to me. It is through listening and connecting that we can foster real empathy and meaningful change.
Ean Hudak (Biochemistry, ‘26)
I was placed originally on the first aid station of the health promoter, but soon after we began caring for patients I was pulled to blood pressure and pulse oximeter. As I took blood pressures manually, I saw some values that were within the prehypertensive and hypertensive ranges, leaving me deeply concerned. Many older people that I saw had oxygen saturations that were below 90% which could be due to the pollution in the area and poor access to healthcare. These readings would be addressed quickly in the U.S. with medications and lifestyle changes, but in La Carpio, it would be nearly impossible with the difficulties facing them.
There was a man who had a bandana wrapped around his wrist, and it turned out his ulna was broken after he was assaulted. His arm was reset and casted at the hospital, but further visits were needed to monitor the healing. His wife walked out on him a couple months ago and he became dependent on alcohol. His cast got wet and it came off, and unfortunately, due to the system in place, he couldn’t afford additional visits to the hospital. Luckily, Suzi, a nurse working at the clinic, had a few soft casts in her clinic from physical therapy. We were able to get the man two casts to help with his healing. If we never asked him about his arm, the loose bandana on his arm would have impaired the functionality of both his arm and hand. Language didn’t get in the way of care, even though we spoke different languages. People were able to be heard in their own community. The community was beyond grateful for our visit, but I left asking myself what more could we do. My heart truly goes out to all the refugees, and I hope in the near future, the government will change their social security laws to cover the refugees living within Costa Rica, allowing for equitable healthcare coverage. The stories and faces from the people of La Carpio will be kept with me forever.
Valentyn Sukhhy (Biology, ‘27)
I had the chance to fly to Costa Rica, as an experiential learning trip about its social healthcare system and the effects of the inhabitants. I was given the privilege of helping organize and run the first international Health Promoter Program with the Institute of Clinical Bioethics. La Carpio is an isolated community of migrants from various South American countries, a majority of migrants being Nicaraguans. When migrants conclude their arduous journeys—ones that few experiences in the world can compare to—many find themselves in Costa Rica, settling in La Carpio. This community faces a precarious existence, hindered by negative perceptions from Costa Rican services, as it is surrounded by wastewater disposal sites, massive landfills, cement factories, and rivers that impede its growth and development. With the help of the small clinic and the church’s youth group, they provided us with space and the initial trust with the community to run the Health Promoter successfully. My role was managing the glucose and cholesterol station, pricking the patient’s finger in order to take blood and measure the two measurements mentioned. As more people arrived, I relied on my knowledge of Italian and French to piece together brief Spanish conversations with the patients.
Despite the limited conversations we could have, every patient approached the station with curiosity and interest, leaving either reassured about their health or grateful for the care provided. Some were pleased to learn they had been maintaining good health, while others appreciated our ability to identify critical measurements and recommend next steps. It was unbearable to witness the frustration they carried, grappling with medical issues while having no one to rely on or turn to in their times of need. Being able to listen to them and hear their stories and struggles was truly a moving and unforgettable experience. As Paul Kalanithi defines a patient as “one who bears hardships without complaint,” the La Carpio community exemplifies this sentiment, embodying resilience in every sense.