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One side for adults, and the other side for children, because the number of deaths was so high. Salas grew up in a small, red-roofed farmhouse just down the road. He slept on a straw mattress, with a woodstove in the kitchen, and no plumbing. Still, his family was among the better-off in Atenas, then a community of nine thousand people. His parents had a patch of land where they grew coffee, plantains, mangoes, and oranges, and they had three milk cows.
His father also had a store on the main road through town, where he sold various staples and local produce. On the cemetery road, however, there was another kind of traffic.
The images of the mourners are still with him. In , around ten per cent of children died before their first birthday, most often from diarrheal illnesses, respiratory infections, and birth complications. Many youths and young adults died as well. Life expectancy tends to track national income closely. Costa Rica has emerged as an exception. Searching a newer section of the cemetery that afternoon, I found only one grave for a child.
In the United States, life expectancy peaked at just under seventy-nine years, in , and has declined since. People who have studied Costa Rica, including colleagues of mine at the research and innovation center Ariadne Labs, have identified what seems to be a key factor in its success: the country has made public health —measures to improve the health of the population as a whole—central to the delivery of medical care.