QCOSTARICA – The dusty soil of the border trail made the midday heat of Thursday, February 17, feel even more intense in El Bochinche. The vaccination teams knew this and understood that this could complicate the arrival of some people. They knew they would get the job done.
Cataloging this neighborhood as Costa Rican (Tico) or Nicaraguan would be incorrect: it is binational. One part is located in Medio Queso de Los Chiles, but a few hundred meters away are the first Nicaraguan houses. There is no border, no marker, no dividing line.
“Welcome to Nicaragua,” Melvin Anchía, an epidemiologist from the Huetar Norte region, told my partner John Durán and me as we walked a few houses in the barrio (neighborhood). We looked at each other again in disbelief, but Anchía was right.
The difference between one country and another was like crossing an ‘alameda’ (walkway or promenade) of San José. It wasn’t even the width of a narrow street.
It is precisely in the places where the maps mark the border, Anchía continued explaining, where paradoxically the borders are blurred and the communities live as if the nationalities did not exist.
“The border entanglements only exist for Managua and San José, here for us everything is the same”, I remembered the words that someone who lived in the vicinity of the San Juan River and who had family in both countries had said to me some time ago.
In El Bochinche, the border trail is not as a dividing line, rather it is located several meters inside the Tico side. The families that lived right on the border did not lose their houses. In the community adjacent to the trail, there are 225 houses in Nicaragua and 64 in Costa Rica, where 1,012 and 202 people live, respectively.
That Thursday, the task of the staff of the Caja Costarricense de Seguro Social (CCSS) was to first vaccinate the children of the community, complete schedules for adolescents and adults, and apply some booster doses. The rows began to form slowly in a room next to an evangelical church, facilitated by the pastor.
Arturo Montano, technical assistant for primary health care (ATAPS) and Hugo Montano, nursing assistant, got settled in and got everything ready. The cousins greeted each of those who arrived, as many have known them for years.
Little mattered the country where the attendees were born. All have easily demonstrable roots with Costa Rica and that is why any of the residents could participate in the vaccination campaign.
Some mothers arrived with their children’s vaccination and health monitoring records, others with their birth certificate. Adolescents and adults with cedulas (identity cards, both national and residency), employment records, driver’s licenses, or any other document that identifies them.
Ashlin Daniela Masín, nine years old, was the first, she is also one of the first girls to receive the covid-19 vaccine. Mileidy Génesis Mendez, three years younger, followed her.
Due to the remoteness of the area, this vaccine arrived when the country had been vaccinating children for about a month. For this same reason, here no distinction is made of age or risk factors to participate in the campaign.
“For us, going to an Ebáis or clinic is a matter that takes a whole day, it takes a long time. Here you may have to wait more days for them (vaccines) to arrive, but they come close to the house,” said Ashlin’s mother.
For the vaccinating team, the document or the country of origin or residence did not matter, it is a dynamic to which they are accustomed to, since there is a long history of attending to binational health needs. This is how vaccination has always been, not only against covid-19, children in these areas have all their vaccinations up to date thanks to this type of strategy.
“From the point of view of public health, being a cross-border population, it is very beneficial for the country to maintain good coverage on such a porous and vulnerable border,” the specialist stressed.
This is not the only community on the borderline and even in towns further from the limits in either of the two nations.
In places like Mojón 8, Mojón 9 or Esperanza, all on the Nicaraguan side, binational families are a constant. Many of its members work on Tico soil and their children also study there. Some of the vaccines are received in Pinolero (Nicaraguan) territory, but most of the vaccines are administered in Costa Rican territory without any problem.
It is not just a handful of people who live like this. Only in these three communities there are 445 homes in which 3,870 people live, according to data from the Caja.
Not everyone lives there full time because they depend on the harvests and the informal jobs that they can get, so they come and go. This migratory dynamic makes their access to health care more complex.
The same thing happens in ten other communities located entirely in Costa Rica, but where it is regular to cross into Nicaragua daily or several times a week for different activities.
Santa Fe, Asentamiento Santa Fe, La Primavera, Las Delicias, Medio Queso, Coquital, Isla Chica, El Cachito, Punta Cortés and Cuatro Esquinas make up different neighborhoods and hamlets with some 1,308 homes, in which some 4,196 people reside.
These are towns in the canton of Los Chiles, but very close to there, in Pocosol or Cutris de San Carlos, there are neighborhoods with the same characteristics of binationality and the same approach to public health.
These binational communities are also seen in other areas separated by the San Juan river in different parts of Sarapiquí, or in communities near Upala or La Cruz de Guanacaste.
“It is a dynamic throughout the border corridor, with different types of crossings. People enter, leave and coexist. That everyone is vaccinated is a way to protect each other, “said Anchía.