Doctor's Review: Medicine on the Move

December 8, 2021
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Boundless Costa Rica

Rainforests, volcanos, wildlife, generous and outgoing people, two oceans -- even medical conventions. How could an MD wish for anything more?

The two-hour bus ride ended at a banana plantation. We picked our way down a narrow path to the water and clambered aboard a launch, powered by twin 85-horsepower Mercury outboards. This was our African Queen: the men imagined themselves Humphrey Bogart, the women Katherine Hepburn. The river was dangerous, but we were in love with the idea of adventure.

For two hours we churned through a lacy network of waterways. The rainforest towered on either bank and we kept our eyes peeled for toucans, howler monkeys, iguanas and the small-but-deadly cayman crocodile. The forest divided and we saw a dugout canoe pulled up on shore, a thatched-roof house and some empty gas cans. Skinny dogs raced along the bank and barked at our boat's wake.

An hour later, I was sitting down to dinner at Pachira Lodge in the heart of Costa Rica's Tortuguero National Park, a vast reserve on the Caribbean coast that runs all the way up to Nicaragua. In the dinning room, which was open on all sides, the squawks and whistles of exotic birds wafted in on a soft breeze. I glanced over at another table as I dug into a plate of gallo pinto, seasoned beans and rice, often eaten for breakfast. Five young couples sipped cocktails and bantered back and forth in Spanish. Their adventure clothing was new and stiffly pressed.

In the bar after dinner, each couple told me they were married the previous Saturday in Madrid. They met for the first time here in the jungle in the heart of Central America.

The next day a group of us hiked up Tortuguero hill, the highest point for kilometres around. Our guide, Erik Bieta, told us about the rainforest's thin soil and the massive roots that sprawl across the ground in search of nutrients. The previous week, a storm came through and took out a 45-metre kapok tree which, in turn, brought down the dozen trees surrounding it. The new clearing in the forest was flooded with sunlight, which will allow for new plants to grow. Bieta pointed to a long line of ants making their way to a cache two metres underground. Each ant carried a green leaf the size of a penny that was being cleaned of unwanted parasites by a nurse ant. In the cache, the leaves will be chewed up and then spat out. The fungus that grows on the decomposing leaves will provide food for the eight-million strong colony.

In the afternoon, we cruised by the biological station that protects the green turtles. Since its establishment in 1954, when the species first faced extinction, the station has tagged more than 26,000 turtles.

Farther on, we pulled into a makeshift dock to pay the $9 visitor fee that Costa Rica now charges tourists visiting any of the country's national parks. The fee raised just over $3 million last year but much more is needed if areas such as this one are to be protected from deforestation. The government has pledged $750 million to buy back private land, without any idea of where the money will come from.

The launch edged back into the current and we received our first lesson in identifying birds and other wildlife. The real bush is not at all like a scene from a Tarzan movie, with monkeys swinging from vines and flocks of toucans and parrots nattering on every branch. The rainforest is dense and impenetrable, the fauna wary and well camouflaged. It takes a skilled eye to spot anything other than leaves and towering trunks. Lucky for us, Bieta had such an eye. We spied an osprey high in a tree, snowy egrets, blue herons, a bare-throated tiger-heron, a needle bird and a snake bird. On branches reaching 25 metres over the river, we saw giant iguanas lying in the sun. As we rounded a corner, there was a splash in the water and we caught a glimpse of the Jesus lizard (it can walk on water, thanks to its long toes and speed).

Our second excursion began at dawn the next day. We were rewarded with sightings of the large keel-billed toucan, the chestnut-mandibled toucan and the yellow-eared toucanet. Three of Costa Rica's many monkeys, the tawny spider, the howler and the white faced capuchin, were spotted feeding in trees along the shore.

I was back on the road again, climbing the Tileran range toward Monteverde, the country's famous Cloud Forest Preserve. The previous night, I stayed on the Atlantic side of the continental divide at Bosques de Chachagua, a charming set of cabins in a park-like setting practically built into the mountain. The property, owned by Carlos Salazar, has hiking trails and a working farm which includes horses, goats, geese and ducks, peacocks and two formidable pot-bellied pigs, all supervised from the front porch by Saralita, a scarlet macaw.


For dinner I went to the Tabacon hot springs, a river of hot water that runs down from the Arenal volcano. It was cloudy, so I missed the fiery forks of lava which encircled the mountain's cone, but I did stop for a long soak and romp in one of the spa's many pools and waterfalls.

The Monteverde Cloud Forest Preserve is justifiably the most famous in the country. Rising from 600 metres to the continental divide at over 1800 metres, the misty forests are home to nearly 400 species of birds, 120 species of lizards and frogs and 100 species of mammals, all set among nearly 2500 different kinds of trees and plants. There are over 400 species of orchids alone in this preserve, which was begun by Quakers in 1954 with a scant 544 hectares. It has since expanded to about 10,500 hectares. Given the amount of wildlife, you'd think that you could scarcely take a step without stumbling over some exotic plant or animal. But here, as everywhere else in the country, the fauna -- except for butterflies and humming birds -- is intent on staying out of harm's way.

As a kid, our guide Adrian Mendez liked to come out and watch the trees being cut down. Rainforests are unique in that all of the nutrients are held in the vegetation rather than the soil. Deforestation quickly leads to impoverished soils that are easily eroded. Mendez took me to a section of the forest that's had 40 years to grow back. The rate of growth is impressive, but Mendez doesn't think we'll be able to stop the destruction of our forests in time to allow vegetation to grow back. He pointed to a resplendent quetzal, a sacred bird that was prominently featured in Mayan and Aztec mythology. Through Mendez's powerful telescope, I watched it feeding in the canopy of a tall, fruit-bearing tree.

The birds of the preserve were spectacular. We saw 24 different species, including six different kinds of humming birds. That afternoon after a beautifully prepared lunch at the Trapp Family Lodge (the owner is a cousin once-removed of the famous Sound of Music horde), I signed up for Sky Trek, another mountain thrill. It was billed as a chance to get a bird's-eye view of the forest canopy, but this was no trek for nature lovers. Gussied up in climbing gear, I was suspended in the wet and wind from a stainless steel clothesline pulley and sent out along a series of cables that swing between platforms, high in the trees. Some of the cables, which are 300 metres long, scream over gorges 140 metres deep.

Supper that night at the Belmar Hotel was much appreciated. It had a Swiss chalet look to it, with a staff and cuisine to match, but with a Tico touch (the name Costa Ricans give themselves). The hotel staff were a lot friendlier than the Swiss, yet just as efficient. The country food was tasty and nicely prepared and presented.

The next night found me at the elegant Los Suenos Marriott on the Pacific side of the country. Canadian doctors will likely become familiar with this establishment if they're not already. A host of conventions are scheduled here, including an SOGC event next March. The hotel, which has recently opened, features a golf course, casino and a series of dinning rooms that meet Marriott standards anywhere. There were dozens of secluded places in which to swim and sunbathe in the 2300-square metres of meandering waterways that flowed under bridges and among terraces of tropical plants. While you're there, visit the nearby Carara Biological Reserve. This 'drier' rainforest resembles the conventional idea of a typical one: tall trees, arching canopy, masses of vines and luxuriant undergrowth. The reserve is home to the endangered scarlet macaw. Every evening, at around 5pm, they return after a day of feeding in the mangrove swamps at the mouth of a nearby estuary. The swamp is worth the visit to see the crocodiles, as the birds are hard to see from the water. The best tour is offered by the Grupo Mawamba. Ask for Charlotte as your guide.

The Costa Rica Marriott is a half-hour drive from San José and has complete facilities, including an excellent golf course. San José has hundreds of places to stay, from the Aurola Holiday Inn downtown, to inexpensive homesteads where you board with a family. You should consider staying at the Marriott for a night or two when you first arrive, as San José is not a particularly easy city to get used to. It is large, with a population of over two million, messy, polluted, poor and somewhat dangerous.

I recommend taking a tour out of San José to the aerial tramway in a 'wet' rainforest, just 45 minutes from the capital. The trip through the canopy to tropical gardens 50 metres in the air will give you a taste of what's to come on your eco-tours.

My trip to Costa Rica took a zig-zag, diagonal path across the country, from southwest to northeast and was crammed into a busy ten days. It was a good introduction to the country and left me planning my next visit before I boarded the plane for home.


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