ATAP= Asistente Técnico de Atención Primaria, or Primary Care Technical Assistant.
Ever since my first introduction to the Costa Rican healthcare system, the ATAP has been the most fascinating aspect to me. According to my professor, and I agree, they are the main reason Costa Ricans' health has improved so dramatically. Because the Caja is so committed to bringing universal, equitable healthcare to everyone, they don't just wait for you to come to the doctor when you're sick. They send out these special technicians to bring your health care to you. On a motorcycle.
Their job is primarily on the preventative side of the public health spectrum, so every day they strap on their helmets and zoom along through the green country roads, paying a visit to all the households in their region giving out vaccines, or updating the "ficha familiar" -- the family survey -- where you record a detailed medical history of each member of the household, notes on family dynamics, as well as every detail you'd ever need to know about the house (housing and roofing materials, waste disposal system, number of bathrooms, really everything). They know everyone, and at any given stop, they'll have a cup of coffee, be given sweets, or have a look at a family's baby cow... I'll actually be using these fichas (all in paper form) for my independent research project, in which I will identify high-incidence locations of acute diarrheal illnesses in the community, describing their seasonality and then trying to pinpoint possible causal factors.
Anyway, today our group split up to shadow some ATAPs. We tell people that we are medical students, because here there is no such thing as undergraduate studies and people begin their medical training at 18 or whenever they graduate high school. Half of our group actually got to ride on the backs of the motorcycles... I unfortunately was not one of them, as my mother will be ecstatic to hear, because one of the ATAPs had already left on his rounds, and the other was injured (try putting together the pieces of that one). The one that was left took Matt, Mallie and me to a Casa de Salud, which is a house owned by the Caja in a remote area that's only visited by a doctor maybe once a week, but where other health promotion activities can occur. I met a very energetic woman who teaches aerobics to seniors at the house every Monday, and she complimented me on my eyes, saying that her grandsons have blue eyes like mine, and gave me a big hug and kisses!
Today was flu vaccination day for the elderly. I'm not sure how the word gets around about what's going on, but we got about 10 patients in the 4 hours we were there. It was mostly women bringing their cute, elderly mothers to get their over 65 benefits. Our ATAP, "John", was really funny and enjoyed practicing his English with us. He decided he'd spice up the slow morning a bit by teaching us to give injections! We couldn't use the gripe vaccine, but he happened to have some extra Diptheria/Tetanus vaccine in his cooler-- so who's first? John gave Matt the first shot, then showed Matt how to give an intramuscular injection on Mallie. Mallie did me, and because they had both been injected, the first shot I ever gave was to a 76 year old woman named Esperanza. Of course, I had to act like I do this all the time, but it was one of the craziest things ever. Sooooo cool.
Amazing day!
Besos
Sooooo cool indeed! Another intriguing possibility for U.S. healthcare - deploying ATAP types again, as our govt sent visiting nurses out to impoverished communities under the 1930s New Deal.
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Auntie Ann
uck! I could never give or get shots from friends!
ReplyDeleteWere the students passing out left and right, or is it just me?
(ps, I have a history of crying hysterically at the doctors, yeah, I was THAT kid)
sounds like an exciting adventure, say hello to esperanza for me!
If you ever try to come near me with a needle you're gonna get a front row show of the skills that earned me a pink belt with two stripes back when I was six years old.
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