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Volunteer Voices: International Cancer Corps Volunteers in Costa Rica

Mar 11, 2014


An Interview with ASCO Volunteer - Claude Denham, MD

From left to right:
Dr. Carlos Zuniga,
Dr. John Pippen
and Dr. Claude

What made you interested in
volunteering? Why did you choose to
go to Costa Rica?

This was my second trip with HVO (we
spent a little over a week in Hue,
Vietnam in 2012). I have always
wanted to go on medical volunteer trips
for many years now, but it seemed like
the main desire was for surgeons who
could come in and perform a one-time
procedure or primary care doctors who
diagnose and treat infectious diseases.
In a sense, I felt left out as a medical
sub-specialist. These HVO/ASCO trips
though provide a great opportunity to
collaborate with oncologists from other countries who may
feel a little isolated and perhaps a little less confident in their
management in comparison to what they read in journals. I
had been to Costa Rica several years earlier for vacation and  
generally found it a very easy trip for an American.

What surprised you about your visit to the hospital in
San Jose?

I was somewhat surprised and very impressed with quality
of the clinical care, multidisciplinary conferences, and
knowledge base of the oncologists at all three hospitals.
Our discussion of patient management was much more a
two-way collaborative discussion considering the differences
in our health care systems than a purely didactic teaching
exercise. The health care system in Costa Rica struggles
with escalating need for technology, including advanced
imaging and expensive drugs just like the US. There is a
difference in expectations on the part of the patients, but
the oncologists spend a great deal of time filling out forms
and jumping through hoops to get newer drugs for their
cancer patients. This was very notable and impressive.

What lasting impressions/effects do you think your
visit might have?

I hope our trip provided them with reassurances that, within
the constraints of their healthcare system, they were doing a
remarkable job taking care of cancer patients. They have
structures in place for very effective multi-disciplinary cancer
treatments already. At present, there is apparently no access
to clinical trials in the country, but my understanding is that
this needs to be addressed at the national governmental level.
By discussing our access to clinical trials, perhaps the
oncologists in Costa Rica may be enabled to convince their
government to establish a process for this in the future.


By Patsy B. Aday, RN, BSN, OCN

Chemotherapy infusion center at
San Juan de Dios
Since becoming a nurse 14 years ago, I have dreamt of participating in an overseas medical volunteer trip. However, a religious-based mission trip was not what I was seeking. When three of the physicians and one of the nurses (Josephine Divers, RN, BSN) at my workplace decided to visit Costa Rica, I requested the opportunity to join them. What a fantastic way to fulfill my dream!

Through Health Volunteers Overseas (HVO) and ASCO, we were able to spend a week in San Jose, Costa Rica working directly with hospital oncology staff. We visited two hospitals: Hospital de Mexico and Hospital San Juan de Dios. The facilities were different in many ways, yet very similar in so many others.

At San Juan de Dios, the older of the two hospitals, the chemotherapy infusion room was in a basement with minimal natural lighting and approximately 50 reclining chairs lining the walls. Families stand beside their loved ones due to lack of space.

 Tree of Hope from Hospital de
By comparison, Hospital de Mexico contrasted sharply with de Dios. Having recently completed a new cancer center, the staff enjoys the luxury of a state of the art infusion room. The center is open, brightly lit, and built around the “Tree of Hope;” a place for visitors to reflect, meditate, or simply enjoy nature.

The care provided by the nursing staff at both hospitals is phenomenal. Josephine and I were quite impressed with the patient education and compassion provided to all patients. I was expecting to experience a place where the information and care were behind the times. What I found was the complete opposite. The nursing staff is well educated (many have Master degrees) and exhibit current knowledge of infusion therapy standards/protocols. They perform their jobs with enthusiasm, knowledge, empathy, and skill.

Josephine Divers, RN, BSN, working
with the local nursing staff in San Jose

The nurses are very interested in finding ways to increase their knowledge and skills in an effort to provide better care. My colleague, Josephine has been in contact with the Oncology Nursing Society (ONS) International division in an effort to begin an ONS group in Costa Rica. This would allow the nurses at different facilities to come together to learn and share knowledge.

For those medical professionals looking to begin a life of volunteering, Costa Rica is a great place to start. We felt quite at home in both hospitals. We were welcomed with open arms and enthusiasm from all staff. Josephine and I developed new international friendships that we hope to continue for a very long time. A dream come true!
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