On Thursday, we drove to Costa Rica’s rainforest canopy. It was amazingly lush, filled with all kinds of insects and animals, and humid! At Turu Ba Ri park, we were able to ride zip lines across the canopy for an amazing view of wild Costa Rica, and take a horseback tour. While on our tour, the guide told us about Costa Rica’s national tree, the guanacaste. The guanacaste is a large, shady tree, which is nice, but what really blew me away was the meaning behind the tree. Guanacaste means “EAR TREE” in the native Costa Rican language! When dried, the fruits of the tree look like curled ears. Native tribes would use them as soap and also shake the sead pods as instruments in religious rituals. Of all of the souveniers from this trip, I think the “ear” from the guanacaste tree will be my favorite. What an amazing coincidence!
From Turu Ba Ri, we headed further toward the coast to the beach. Wow. You have not experienced nature until you have opened the toilet to find a frog making itself at home, or been woken by monkey calls at the break of day. We experienced natural Costa Rica during our beach adventures!
On Friday morning, we went to the town of Liberia to perform screenings at the San Rocque school. The school serves primary grade children (grades 1-6) from a very, very poor region of Costa Rica. Unlike the students we screened at the Cen Cenai, these children were older (about 9-12 years old), so we did not perform the preschool cognitive screen, just hearing and vision exams. Surprisingly (or not so surprisingly), we had a very high refer rate for children with hearing problems at this school – about 1/3 of the children referred for further hearing testing. This could be due to untreated ear infections, noise-induced hearing loss (from loud cars, farm machinery, loud classrooms), syndromes (though we cannot diagnose, it did appear that several of the children in the school had characteristics suggestive of various syndromes), or many other factors. We saw and tested one little boy with microtia/atresia (malformed ear and canal).
The memory of one child I tested will stick with me for a long time. She was a twelve-year-old little girl who showed no response to tones as high as 90dB, yet she was able to answer my questions and speak beautifully (progressive hearing loss, maybe?). As I was performing the screening and seeing the results, I was more and more concerned. At the end of the test, I asked her, “How well do you think you hear?” and she immediately shared that she did not hear very well, and often had problems in school, watched TV too loud, and had to ask her mother and her friends to repeat themselves often in conversation.. I was able to speak with her teacher, a wonderful woman who was already making some great accommodations (projecting her voice, preferential seating for the student) and suggested a few more (repeating classmates’ questions, not talking while facing the board). The teacher said that the girl’s family is very, very poor. Because she is twelve, she is too old to be treated by the Children’s Hospital that we visited earlier on this trip (children over 12 go to adult hospitals in all but very rare or chronic cases). Instead, she would be referred to her regional government hospital, which may or may not have audiological services. Honestly, I was ready to drain my bank account right then to buy her some hearing aids, but what then? What audiologist would fit and adjust them? Who would pay for batteries and new earmolds? How would she find or pay for transportation to and from appointments? it was heartbreaking. I don’t think you can see things like that and not come away changed.
We conducted the screenings in the school’s special education resource room. I was so impressed that such a poor rural school was really making an effort to provide for ALL of their students, despite their limited means. The special education teacher told us that she could have up to 14 children in her class (any more and the government would make her split it into two classes and hire an aide or another teacher), but that she never knew who would walk in the door. Whatever special need, no matter how big or how small, is her responsibility. She did not currently have any students with hearing loss in her class, but she had taught some D/HOH children in the past and was eager to read the resource packet we had prepared to leave at the school. The classroom itself was sparse, with just a few desks and chairs. The school had not cleaned it out in preparation for our arrival. Instead, those three or four mismatched desks and chairs were all the furniture that classroom had. The teacher said that because there were not enough chairs to sit on, seats in her class were “first come, first served”, Unbelievable. The children don’t even have seats, and yet they were some of the most well-behaved and loving children I have ever met in my life. The teachers, despite the utter lack of resources, strive to do their best for ALL of the children in their care (not jut the typically developing ones), and were gracious hostesses to us during our time at San Rocque.
Andrea, my Costa Rican classmate, told me that the children at the school receive a free lunch (maybe their only meal of the day), and that when they graduate from sixth grade, many do not go on to colegio (high school) – either because they have to work to support their families, or because the bus ticket to get to the school are cost too much.
Elizabeth A. Rosenzweig 