La Clinica de la Mariposa: Serving the People of Costa Rica

By Editorial Staff

Creating and sustaining international health care programs is a long-term and labor-intensive process. Volunteering your time to provide gratis care can be a life-changing experience. Those who participate come into close contact with another culture, providing the opportunity to grow in sensitivity and the ability to care for others of a different culture.

While most Americans are blessed with access to basic health services of one form or another, in many countries, even basic health service needs are poorly met. In 2000, a volunteer service clinic called La Clinica de la Mariposa ("The Butterfly Clinic") began providing chiropractic care to underserved and underprivileged residents of Costa Rica. La Clinica is affiliated with the Christian Foundation for Children and Aging (CFCA), an organization that provides invaluable neighborhood (barrios) community workers called las promotoras. Las promotoras are residents in the barrios who organize the clinic logistics, including patient scheduling and the noon meal for the staff.

La Clinica is a mobile clinic that takes portable treatment tables and supplies to different locations each operation. At present, two trips per year (three to four weeks each) offer the clinic opportunity to the residents in the Central Valley of Costa Rica, and in the more distant towns of San Ramon, Cartago, Alajuela, Limon, and Los Chiles. Volunteer health care students (chiropractic, massage therapy and acupuncture) and supervising professionals provide assessment and treatment to patients.

The mobile clinic covers 10 CFCA-sponsored communities during the course of the current two annual visits. There are nearly 2,000 patients currently being served by La Clinica de la Mariposa. Patient records are maintained and available during the clinics, and patients usually visit La Clinica two or three times during the volunteers' stop in their communities. This means that La Clinica provides continuing oversight and ongoing care to patients - a unique feature of this clinical experience. La Clinica is therefore patient-centered, truly attempting to meet the needs of those served, rather than a one-time, short-term experience. Moreover, this model, using service-minded volunteers and local community social-service programs together, provides a meaningful encounter which could be implemented in other locations.

Housing is provided for student volunteers in apartments near Heredia, a suburb of Santa Lucia. Some professional volunteers have chosen hotels in the Heredia area because this offers easy access to public transportation. On clinic days, volunteers travel in a van or bus to and from the communities where service is provided. Lunch is included on day trips. If travel is to remote areas, transportation, lodging and food are provided for the volunteers.

In 2003, Santé, Inc., a tax-exempt, nonprofit organization, was formed to facilitate fundraising for the current project in Costa Rica. While the primary goal of Santé in Costa Rica has been to provide health care services through La Clinica de la Mariposa on an ongoing basis, there are also plans to develop and expand the range of mental health services. Santé is in the early stages of developing a means to serve abused women and children, providing counseling services involving selected and trained staff members (las promotoras), and professionally trained counselors. Finally, Santé is developing plans to begin a major capital project: the purchase of a suitable property and construction of a secure and adequately sized building to serve as its headquarters in Costa Rica. The building will be used to store supplies and patient records, and will also serve as a conveniently located clinic site.

La Clinica is an experience that combines service objectives and learning objectives with the intent that the activity will change both the recipient and the provider of the service. This is accomplished by combining service tasks with structured opportunities that link the task to self-reflection, self-discovery, and the acquisition and comprehension of values, skills, and knowledge content. Volunteering time and/or donating money, supplies or equipment will provide support for an ongoing clinic experience in Costa Rica. Financial support is especially welcome to subsidize student costs and to assist in operating the clinic on a long-term basis. Additionally, doctors of chiropractic from Minnesota have the opportunity to earn up to 10 hours of continuing education credit for a week of work through Northwestern Health Sciences University. For more information or to make a donation, visit the Santé Web site:

Article submitted by Dr. Thomas Bergmann, professor (chiropractic department) at Northwestern Health Sciences University and Santé board member; and Dr. P. Thomas Davis, faculty researcher at NHSU and current chairman/CEO of Santé.

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