Aid comes to the mountains
A Cabécar boy climbs a tree to watch the arrival of a medical team from the Social Security System to the area of Alto Telire, in the Talamanca Mountains, one of the most remote and vulnerable communities in Costa Rica. See story at right. Courtesy of Lucas Iturriza
From the print edition
By Lucas Iturriza | Special to The Tico Times
ALTO TELIRE, Talamanca – Deep in the Talamanca Mountains live Costa Rica’s most isolated residents – families of Cabécar whose homes are so remote that few people know of their existence. The area known as Alto Telire is situated in such rugged terrain it can only be reached by helicopter or a grueling and dangerous trek through the mountains.
For the region’s Cabécares, one of Costa Rica’s eight indigenous groups, civilization starts at Vesta and Gavilán, which like other Costa Rican villages have pulperías (small grocery stores) and electricity. Hiking from the mountainous outpost of Piedra Mesa to one of the more populated areas can take three days, heading down the mountain. In the opposite direction, an uphill trek to buy supplies, such as sugar, clothing and rice, can take up to six days.
Frequent dangers envelop travelers, include swelling rivers from heavy rains – which claim lives constantly – tiny trails that disappear in a storm, snakes, landslides and the rugged trail itself, which becomes treacherously slippery. Falls are common, causing frequent ankle and knee sprains. During one journey, a Cabécar man fractured his arm during a fall. Because of heavy rains, 15 days passed before medics could airlift him to a clinic. But doctors could do little to save his arm, which they were forced to amputate.
By helicopter, the journey to Piedra Mesa lasts one hour from San José and 30 minutes from Bribrí, a larger indigenous community to the east.
The Costa Rican Social Security System, or Caja, has provided medical assistance to these isolated areas for decades. During the first medical missions, Caja doctors, along with other volunteers, would hike to the region, visiting each house along the way. The trips were long and arduous, but extremely gratifying, say participants in the early trips.
In 2000, a growing awareness of the plight of the mountain villagers enabled volunteers to collect private donations, which included money, supplies and helicopter flight hours. Helicopters made the area considerably more accessible, and a new chapter was begun in the history of medical missions to the region. But the Caja still hadn’t yet become officially involved in the project.
Dr. David Montenegro examines a young patient at a mobile EBAIS clinic high in the Talamanca Mountain Range. Doctors say the region’s health indicators are similar to those of Costa Ricans a century ago. Courtesy of Lucas Iturriza
Dr. Wilman Rojas, director of the Caja’s Talamanca Health Area, recalls those earlier days: “When we looked at the infant mortality rates in the Talamanca region, we discovered there were 27 deaths per 1,000 births, and in Telire, the rates were even higher, at more than 100 deaths per 1,000 births. Those rates justified scheduling more trips, and from there, the Caja created a fund for medical missions to the most vulnerable communities.”
According to Rojas, communities in the area have an epistemological profile similar to Costa Ricans who lived 100 or 200 years ago, and common problems include respiratory and other infections, pneumonia, diarrhea, and complications from childbirth, among others.
The topography of these millennial mountains has protected and isolated the semi-nomadic Cabécar, hunters, gatherers and subsistence farmers who liken the mountain to their own hearts. It is a matriarchal society where everything is tied together by clan.
For hundreds of years, the only form of survival was subsistence, a hard life without external influences and dependent on hunting, fishing and small-scale harvesting of crops. When the Alto Telire Cabécares discovered the clothing of “outsiders,” they found it to be warmer and more comfortable than the natural clothing made from palm trees that elders used to cover their bodies.
Rubber boots became a necessity, making it easier to montear, or walk in the mountains, and hunt for several days. Boots led to fewer injuries and allowed them to travel faster and farther.
The same was true about new weapons and bullets – the Cabécar left behind bows and arrows, and nearly the blowpipe, which they still use today. They also began using other basic items from the outside world, including flashlights, batteries, cooking pots and pans, machetes, soap, bleach, blankets, salt and sugar.
Up in the mountains, there are no jobs, no paychecks, no bosses. Everyone pitches in to take care of the family, protect the clan and grow crops of bananas, plantains and cassava on small plots of farmland.
Still, food is scarce, and population growth has made hunting increasingly difficult. Finding money for purchases at “outside” markets – something that has become a basic necessity – is challenging. In order to earn a few colones, those old enough for migrant labor travel to El Valle de la Estrella (Valley of the Star) and work clearing land for ₡5,000 ($10) a day. They also toil in banana plantations, where they stay for up to six months before returning back up the mountain with as many supplies as they can carry: clothing, food, a new machete, a radio.
A helicopter’s view of Alto Telire, Talamanca, in southern Costa Rica. Courtesy of Lucas Iturriza
There is another way to earn some money for the Alto Telire Cabécares: marijuana cultivation. Locals barter the illegal crop with drug traffickers in exchange for basic items marked up at inflated prices. Legal crops like coffee and bananas are less profitable – transporting crops down the mountain takes days and selling them at competitive prices is nearly impossible.
Marijuana, however, can be grown in remote areas where there is no permanent police presence, and buyers come looking for the product, even offering to transport it down the mountain. Marijuana also fetches higher market prices than other crops, providing growers with just enough income to survive. Although not everyone is involved in the marijuana trade, many are.
But there are dangers involved, and officials from the National Police conduct frequent search-and-destroy operations in the area. Because of the raids, police have managed to drastically reduce marijuana production in the past 20 years.
Aid workers have attempted to provide area residents with the means to grow alternative crops, but the efforts have achieved little. Transportation is the biggest hurdle, and there is no official government policy to address the issue.
Two decades ago, Telire was a violent place, and killings happened frequently. Locals say Mexican and Colombian drug cartels used to operate in the area, and indigenous marijuana plantations measured 10 hectares or more. But the violence mainly took place between local clans, who would attack each other on trails to rob money and marijuana. Ambushes, murder and disappearances were common.
Families often responded to the violence with more violence, carrying out revenge killings that targeted other clans, forcing many to leave their homes in fear.
A young Cabécar girl from Alto Telire waits for free medical attention. Courtesy of Lucas Iturriza
In 1992, authorities began to respond to the bloodshed, and in time they were able to scale it back. Today, local Cabécares cultivate significantly less marijuana than in the past, and there is less violence. But there are many other risks.
“Before, these trips were incredibly difficult,” Rojas acknowledges. “At first we’d go up the mountain accompanied by police, but locals didn’t trust the police because they carried out raids and burned their [marijuana] plants. So we decided to separate medical missions from the police and stop using police helicopters, and that made a big difference. Residents began to associate our blue and yellow helicopter with doctors and medicine, and they started to accept us into their villages.”
The blue and yellow helicopter takes off from Tobías Bolaños International Airport, in the western San José district of Pavas. On the helicopter’s side is the circular logo of the Caja. I find myself on one of these medical flights to Alto Telire, my second trip to the region, to document the Caja’s work in this Cabécar community of 300-500 people, Costa Ricans who stoically resist an ocean of adversity.