CENTER FOR INTERNATIONAL PROGRAMS
Course name: Costa Rican Health Care and Tropical Medicine
Course code: HIS-3293
Total contact hours: 60 hours
Pre-requisite: Must be a Health Sciences student

COURSE DESCRIPTION
Costa Rica´s health care system is unique due to the fact that it´s socialized and has achieved excellent health indicators. The course focuses on the history and development of the public health care system within the context of the Costa Rican sociopolitical and economical situation. It also gives a strong emphasis on how the system actually works and points out not only the strongholds of the systems, but also it´s weak points. A third objective, of fundamental importance in order to understand this system, is the study of Costa Rica as a tropical country. Students will learn about the prevention and transmission of relevant tropical diseases.

OBJECTIVES
1. To study the fundamental aspects of the health in a Latin American country
2. To analyze the structure of the Health System of Costa Rica
3. To recognize the main characteristics of the tropical pathology
4. To develop abilities to understand the binomial health and society within the Latin American culture

CONTENTS
Work Schedule:
Part I
Activity
Special Work
Section 1
- Course introduction
- Costa Rica epidemiology, demography and anthropology.
- Costa Rica?s Health Indicators
Speech topics assignment
Section 2
- Costa Rica?s Health System History
- Habitants from the original nation
Costa Rica?s Private Medicine System
Section 3
- Debate: Costa Rica and USA Health Systems
- Movie: ?Sicko? by Michael Moore
Movie analysis
Visit to the CIMA hospital
Part II
Activity Special Work
Section 4 - Physical Examination and
Patient?s interview
- Test #1 (including health
indicators)
- Parasite Generalities
Review on physical
examination
Part III
Activity Special Work
Section 5 - Protozoaries and diseases
- Helminths and diseases
Case #1
Section 6 - Tuberculosis
- Malaria
- Filariasis
Case #2
Part IV
Activity Special Work
Section 7 - Test #2 (including Malaria and
Filariasis)
- Leishmaniasis
Case #3
Section 8 - Ectoparasites
- Chagas Disease
- Larva Migrans
Case #4
Field trip: depending on the number of students and availability on the different health areas
Part V
Activity Special Work
Section 9 - Ophidic accident
- Dengue
- Paragonimiasis
Case #5
Section 10 Oral Presentations
Final Test

METHODOLOGY
We intend to achieve the above objectives by a series of theoretical and
practical exercises. Students will attend participatory lectures about the history
and development of the social health care system and will also learn about the
private health sector. Sessions will also include a debate that compares the
health system in Costa Rica and in the United States. Discussions and debates
will serve as tools, for students to gain some insight in to the differences in
these two societies and their concepts of health. Lectures and discussion will
be complemented with a visit to one of the main private hospitals in San José,
and contrasted with a visit to one of the primary health care clinics of the public
system.

The course develops a series of participatory lectures about tropical medicine. In order to build a common background, students will learn the most important concepts on clinical history and exploration, relevant to tropical medicine, as well as demographic, epidemiological and environmental concepts.
There are several units that focus on the study of patho-physiological concepts and specific diseases, all this, in order to understand the fundamentals of prevention and promotion of health in the context of tropical diseases.
Audience

This course is structured for International Students attending the Study Abroad program at Universidad Veritas. However, courses are not exclusive to foreigners so a few native student could enroll in this course.

Attendance
Students are only allowed 2 absences (justified or not). The student will fail the course if he/she has more than 2 absences. Students will have a 0 on any assignment evaluated in class (presentations, evaluations, field trips, etc.) if he/she is absent in this class, unless an official document is presented to justify the absence the class after the absence. In this case the assignment will be done this day. An unjustified absence to a fieldtrip will immediately mean failing the course. You can only have two total absences in your elective courses HOWEVER, if you miss more than one day of class in a given month, YOU WILL NOT RECEIVE CREDIT for that particular course.

Electronic devices:
The use of cell phones, smart phones, or other mobile communication devices is disruptive, and is therefore prohibited during class. Please turn all devices OFF and put them away when class begins. Devices may be used ONLY when the professor assigns a specific activity and allows the use of devices for internet search or recording. Those who fail to comply with the rule must leave the classroom for the remainder of the class period.

Behavior
Professors have the right to expel a student from the classroom should he / she:
1) be disruptive in the classroom
2) be under the influence of alcohol or even smell like alcohol
3) Behave in a disrespectful way.
If you tend to be late for class, you will lose 25% of your total grade

EVALUATION SYSTEM
60% Practical work
- Debate about health care systems 20%
- Presentation (Subject will be assigned on the first day) 25%
- Participation and discussion in seminars 5%
- Homework and reading assignments 10%
30% Written Examinations
10% Participatory attendance

Final Exam
Evaluation of the ability of the student to face a health problem and be able to incorporate elements of public health and tropical medicine in the context of the Costa Rican health care system.

BIBLIOGRAPHY (REFERENCE)
1. Valerio L, Fabregat A, Martínez O. Unidades de salud internacional centradas en atención primaria. Cuadernos de Gestión 2001; 7: 100-105.
2. Hardling R, Crook P, Lewthwite P. Burden and cost of imported infections admitted to infectious diseases units in England and Walles in 1998 and 1999. J Infect 2004; 48: 139-144.
3. Cetron M, Jeyston J, Shlim D, Steffen R. Traveller?s Health. Emerg Infect Dis 1998; 4: 405-407.
4. Fortney JC, Steffick DE, Burgués JF, Maciejewshi ML, Petersen LA. Are primary care services a substitute or a complement for specialty and inpatient services? Health Serv Res 2005; 40: 1422-1442.
5. Valerio L, Martinez O, Sabrià M, Esteve M, Urbiztondo L, Roca C. High-risk travel abroad overtook low-risk travel from 1999 to 2004: characterization and trends in 2622 Spanish travellers. J Travel Med 2004; 12; 371-331.
6. DOGC nº 3726-25/09/2002. Resolució sss/2619/2002, de 2 de setembre, sobre la revisió de preus públics corresponents als serveis que presta l?Institut Català de la Salut; p. 16.696.
7. Porter JF, Knill-Jones RP. Quality of travel health advice in higher-education establishments in the United Kingdom and its relationship with the demographic background of the provider. J Travel Med 2004; 11: 347-353.
8. Mora Alvarado, Darner A, Portuguez Barquero, Carlos F and Sáenz Aguilar, Ignacio Saneamiento,educación y su relación con los indicadores básicos de salud en el contexto mundial 2002. Rev. costarric. salud pública, Dic 2005, vol.14, no.27, p.35-45. ISSN 1409-1429
9. Mora Alvarado, Darner A and Portuguez Barquero, Carlos F Propuesta del índice sanitario educacional para pronosticar los indicadores básicos de salud en las américas con respecto a las metas del milenio. Rev. costarric. salud pública, Jul 2005, vol.14, no.26, p.41-59. ISSN 1409-1429
10. Chaudet H, Pellegrin L, Boureau C, Delmont J. Evaluating he use of comprehensive pre-travel database by travel medicine experts and novices for advice building. J Travel Med 2004; 11; 148-154.
11. Behrens RH, Roberts JA. Is travel prophylaxis worth while? Economic appraisal of prophylactic measures against malaria, hepatitis A, and typhoid in travellers. BMJ 1994; 309: 918-922.
12. Packham CJ. A survey of notified travel-associated infections: implications for travel health advice. J Public Health Med 1996; 18: 123-125.
13. Keystone JS, Korzasky PE, Freedman DO. Internet and computer-based resources for travel medicine practitioners. Clin Infect Dis 2001; 32: 757-765.

*Course content subject to change