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Costa Rica has one of the best health systems available in Central America. The health service has joint participation both by private and public firms.
The base of the health system is formed by clinics and hospitals managed by the CCSS, a state entity in charge of health and social security. The CCSS has large scale hospitals in population centers all over the country, and well as regional clinics where they're needed.
The CIMA hospital, in Santa Ana, is an excellent example of private participation in the health system
State health services are free for costarrican citizens.
Private clinics, offering services which range from basic medical consultation to surgery and more complex services are also available and are centered mainly around the metropolitan area.
Ambulance services are also a joint effort, handled by the Red Cross and several private ambulance companies. The Red Cross offers a medium quality service along most of the territory, while private ambulance services offer a rapid response, highly equipped service inside the metro area. Obviously, Red Cross services are free or low cost, while private services have much higher price ranges.
Water quality and safety:
Inside large metropolitan areas, water distribution networks are managed by the Costarrican Institute of Acueducts (AyA). This state owned institute designs, builds and operated water intakes, treatment plants and distribution nets.
AyA guarantees high quality water where it operates, with periodic bacteriological and chemical checks on the systems.
In places where AyA does not operate, regional administration comitees are normally formed by communities and provide water service. The quality of service varies from place to place.
In the metropolitan area water is completely safe and may be consumed without much concern. Due to trace amounts of microorganisms which are sometimes present, new residents may experience a bit of discomfort at the start. However the amounts are small, and the body normally adjusts rapidly to them.
In rural areas water may contain more considerable amounts of microorganisms and contaminants, and consumption may lead to more serious digestive problems.
In general, it's a good idea to consume bottled water at the start and gradually switch over several days to tap water. If you should experience any type of discomfort, consult with a medic, who can advise whether you should continue the transition or stick to bottled water.
A common pitfall which you should watch out for is if you decide to cross the borders into Panama or Nicaragua. Water should not immediately be considered safe outside Costa Rica and near the border areas, where water distribution networks may cross. It's recommended you use bottled water if you go near the borders until you can verify the water is safe to drink.
Diseases and infections:
Basic vaccinations should be enough to keep anyone safe from common viral and bacteriological infections. No additional immunizations are necessary to enter the territory.
A tetanus shot is normally a good idea if you haven't received one in a while and will be visiting beaches or rural areas.
Cholera, which was of concern in the early 1990s has been basically erradicated from the territory and should not be of concern.
Dengue fever has been a recent threat in many of the rural areas. Dengue fever is transmitted by mosquitoes and can be fatal in its more hazardous mutations. Strong efforts have been made by the Ministry of Health to erradicate dengue fever from the territory, and at the present rural areas are safe. Any insect repellent containing DEET should be used as a safety measure in coastal and rural areas.
Digestive infections are common in new residents due to elevated levels of microorganisms which can be found locally in prepared foods. In general, you should avoid any product sold on the street which is not industrialized and packaged. Uncut fruits and vegetables sold on the streets can be consumed if properly washed. Any form of fruit, vegetable or product which has been altered or cut to be sold on the street should be avoided.
Snakes and insect bites:
Costa Rica has a population of snakes and insects which can administer bites and stings if provoked.
Snakes are present in most rural areas where high grasses and natural landscapes exist. Specimens which are poisonous do exist, but are normally not agressive. Caution when travelling in open fields and forests should be enough to keep you safe.
Snake bites are normally not fatal, and serious effects normally take a few hours to manifest themselves, which allows for plenty of time to get the victim to medical care. Check with your local Red Cross or CCSS office for more information on species of snakes present in the area.
Scorpions are present in coastal areas and administer painful stings. The insect may range anywhere from a few to several centimeters in size. Normally the bite is painful but non fatal. Exercise caution if you are prone to allergic reactions to insect bites.
The recent crisis in the US has sparked concerns over anthrax in postal services all over the world. The appearance of anthrax spores in a letter received in Chile has prompted even more concern over the situation.
No anthrax related cases have been found in Costa Rica. Several reports were filed near the start of the crisis, however these all proved to be hoaxes.
Anthrax should not be a concern when visiting Costa Rica. If you want to, following precautions suggested by CDC should be enough.