Health Hats, the Podcast

Health Hats, the Podcast

Costa Rica – Travel with Abilities

February 26, 2023

Costa Rica welcomes travelers with disabilities. Juve Acuna, travel guide, spent a week with us sharing his expertise in flora, fauna, history, & disabilities.

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Episode Notes
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Find FULL TRANSCRIPT at the end of the other show notes or download the printable transcript here

Contents with Time-Stamped Headings

to listen where you want to listen or read where you want to read (heading. time on podcast xx:xx. page # on the transcript)

Proem.. 1

Podcast intro 03:58. 2

Grandfather of disability travel 04:33. 2

Capabilities and preferences 07:07. 3

Building a network 08:30. 3

Preparation 10:51. 4

National Tourism Board 12:48. 4

Building infrastructure for accessibility 13:44. 5

The network for accessibility 16:39. 5

Pride 17:30. 5

Possibilities, safety 19:42. 6

A word from our sponsor, Abridge 21:14. 6

Photo highlights of the trip 21:57. 7

Swimming in the Pacific Ocean 22:16. 7

Howler and white-faced monkeys 23:17. 8

Reflection 24:02. 8

Podcast Outro 24:53  8


Please comment and ask questions


Music on intro and outro by permission from Joey van Leeuwen, Drummer, Composer, Arranger 

Web and Social Media Coach, Dissemination Kayla Nelson @lifeoflesion

Intro photo of Vulture Couple by Rich Rieger used with permission

Photo by Iswanto Arif on Unsplash

Photos taken by Ann Boland, Paul Boland, Juve Acuna, and Danny van Leeuwen

The views and opinions presented in this podcast and publication are solely my responsibility and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute®  (PCORI®), its Board of Governors or Methodology Committee. Danny van Leeuwen (Health Hats)

Sponsored by Abridge

Inspired by and grateful to Ann Boland, Linda and Mike DeRosa, Kate Higgins, Mary Lawler


Il Viaggio Travel Costa Rica – Plan your trip to Costa Rica with us (

Where to Go Bird-Watching in Costa Rica – Tripadvisor

Arenal Hanging Bridges | Experiencing Costa Rica From The Treetops (

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Camino | Danny van Leeuwen Health Hats (

About the Show

Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I’m the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life’s realities in the awesome circus of healthcare.  Let’s make some sense of all this.

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The Show

To see the transcript with images download the printable transcript here


Figure 1: Skywalk hanging bridge in Arenal National Park, Costa Rica

Figure 2: Danny in his chair with our guide, Juve

Just stay in the middle. Stay in the middle? The suspension bridge was six inches wider on each side than my electric wheelchair. I’m good with my joystick, but am I that good? Gulp, I can’t see the bridge’s other end, but Juve knows what he’s talking about.  Juve Acuna Sanchez is the grandfather of disabled travel in Costa Rica. He takes people with spinal cord injuries, limited vision, cognitive challenges, and me on guided tours. He says I can do it. I’m approaching the longest suspension bridge in Costa Rica, 984 feet (a tenth of a mile), stretching 230 feet over the stunning tropical forest canopy. That’s about 30 stories high. OK, I can do this. One hundred feet, so far, so good. Then the bridge starts swaying. By midway, it’s swinging about a foot and a half from side to side.  OMG, I’m afraid of heights. There are people in front of me and people behind me. We stop and let the people in front of us finish, so the bridge sways less. But people keep coming behind and wait impatiently. I remember to start recording using my phone on a selfie stick attached to my left armrest. The sides of the suspension don’t attach to the bridge, only the cables holding it up.  My small eight-inch front wheels slide off the edge.  I’m stuck. My large, powered back wheels pull me off the edge. I’m terrified.  I can’t go back. I have to go forward. A few never-ending minutes later, I make it to solid ground. If you’re reading this or listening, check out the five-minute video on YouTube

Traveling with disabilities is equal parts invigorating, self-satisfying, wonderous, and scary. Great for my spiritual health, especially when I reach the other end of bridges and don’t fall backward or tip over the edge. I live to tell a great story.

Figure 3: Juve Acuna

Juve Acuna with Il Viaggio Travel, our full-time guide, appears to be a grandfather of disability travel in Costa Rica. He picked us up at the airport, stayed with us, drove us, and shared his extensive knowledge of Costa Rican flora, fauna, and history for a week. Let me share some of our experiences, images, videos, and an interview with Juve. Travel is good for my spiritual health. I can do it. I can successfully solve moment-to-moment problems and receive and accept loving assistance. This episode may be best as a video. Check it out on my YouTube channel @dvanleeu. Next, we will hear from Juve describing his journey as a guide for people with disabilities, and I’ll highlight of few of the wonders of our travel.

Podcast intro

Welcome to Health Hats, the Podcast. I’m Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life’s realities in the awesome circus of healthcare. Let’s make some sense of all of this.

Grandfather of disability travel

Health Hats: Juve, hello. Thank you so much for joining us today. How are you?

Juve Acuna: Thanks to you for this opportunity.

Health Hats: We met because I’m in your country, Costa Rica. You greeted us at the airport, and we had a wonderful time. And I’m a person with disabilities, and I came to a travel agent who said they specialize in tours for people with disabilities. How did you end up in the line of travel for people with disabilities?

Juve Acuna: About ten years ago, I started working with this company Il Viaggio Travel. A friend of mine since a long time ago, and I realized that the country needs to be more accessible. The uncle of the company’s owners lives in Spain, and his wife, with disabilities in a wheelchair. They used to bring it here and take it all over. It wasn’t that accessible. We started together as the, all these the National Network of Accessibility and yes seven years ago, we started already like as a for tourists and brought people the idea is that they can do the same that everybody does us, right? For example, doing a zip-line tour. We take them rafting. We have unique chairs to take them off the road on the trails, which has been working well.

Health Hats: It’s, so when you say disabilities, is it? All kinds of disabilities. People who are blind or have deafness. Or intellectual challenges or mobility.

Juve Acuna: All kinds.

Capabilities and preferences

Health Hats: When somebody contacts you and asks you to help plan their trip, how do you assess the person coming to try to make sure you understand their capabilities? Yeah, because everybody’s disabilities are a big word. There are so many nuances to it.

Juve Acuna: Part of the contract they do is from the office when they already have people coming. Usually, they need to fill out a form, okay? And in the form is all the details, and they must explain what kind of disability they have. So, the company looks for a specialized guide.

Health Hats: When we made those two Camino trips, I told you about, I made a short video of my capabilities, so my wheelchair and folding it up and putting it in the car and that I could do some steps. It just makes it so much easier for somebody to see that.

Building a network

Health Hats: One of the things you told me that I found so interesting is that you’ve developed a network of people you can call on depending on how many people are in the party. I was going to say how much risky behavior they want. I didn’t mean that. Do you know what I mean? That swinging suspension bridge and swimming in the Pacific worried me. But you’re saying that people will just do all sorts of stuff. So how did you build this network of people you can call on that you can trust to work with you because you’re one person?

Juve Acuna: It was hard at the beginning. We, as a company, trained the people, tour operators. And we went to the hotels and measured all the doors, bathrooms, and everything so they could be approved to work with us.

Health Hats: Okay, it isn’t just other guides or muscles. It’s the environment and everything.

Juve Acuna: Okay. Everybody must take some courses to manage different people with different disabilities.

Health Hats: Tell me again the name of where we are. What’s the name of this resort?

Juve Acuna: Costa Verde.

Health Hats: One person here seems to be on top of it. Everybody’s nice. But that one fellow knew, the driver of the van, he anticipated everything. That was good.


Health Hats: When we went on the pilgrimage to Spain and Portugal, I trained for that. Now that you’ve had these years of experience, how would you suggest that people who want to travel and who have disabilities how should they be thinking and preparing so that they’re ready? Regarding different surfaces and vehicles: the train, the bus, cobblestones, rain.

Juve Acuna: Sometimes it is hard. People get freaked when they’re doing rafting or zip-lining tours and things like that. We have different packages to sell to different people with disabilities. We always offer various activities while they stay here. So, they choose that. So, it is not a surprise. It’s something that they manage ahead of time. I’ve been bringing people with disability to do any kind of activities even when they cannot move anything.

Health Hats: Somebody quadriplegic?

Juve Acuna: Yes. And they have been doing different activities, and they really enjoyed it. Oh yes. They enjoyed it.

National Tourism Board

Juve Acuna: All the tour operators already know. They already have courses. They already know how to manage different disabilities when they’re blind or cannot walk. Or when they can move a little. The Tourism Board Institution approves all these courses in Costa Rica.

Health Hats: Oh, really? Oh, so it’s national?

Juve Acuna: It’s a national network.

Health Hats:  Was it national when you started, or did it become national?

Juve Acuna: No. We started a national network. But it was tough. But in the end, we just spoke with the Tourism Board of Costa Rica, and they put us into the government. So, the government approved our project, and that speeded things up.

Building infrastructure for accessibility

Health Hats: Wow. That’s great. You told me that you were taking bottle caps and creating equipment. Can you tell us about that?

Juve Acuna: We initiated this donation program from different institutions from the government, private companies, hotels, and industries. They’re donating the tops of the plastic bottles. We collect plastic numbers two, number four, and number five. With this material, we make artificial wood. With that, we do we start doing los pasadizos passageways. So, we make accessible beaches.

Health Hats: Oh, so the boardwalk? Yes, in Portugal, they had that.

Juve Acuna: Before that we didn’t have any accessible beaches. We made houses for the lifeguards and amphibious chairs so they can go straight from the beach into the water and stay in the amphibious chair. Right now, we have twelve accessible beaches here in Costa Rica.

Health Hats: My goodness.

Juve Acuna: And the people enjoy it. When I go to the beach now, there are a few wheelchairs. Now everybody uses local Costa Rican people.

Health Hats: I like that you’re thinking about the infrastructure. I’m impressed that the government has gotten behind it because so much of business in Costa Rica is tourism. I remember a guy I knew years ago, a car salesman. He was in getting into the business and having difficulty breaking in. So, he ended up specializing in transportation for people with disabilities. Most people selling cars or trucks or whatever had no idea about disabilities. And so, he would get all this business from everywhere because they knew this guy. He started an industry and trained other people in other parts of the country. He started with nothing, but eventually, in 10 years, he was very successful. He made a good living.

The network for accessibility

Juve Acuna: The network is how you said when we don’t get any money from there. It’s not-for-profit. But the network is separated, the tourist pays, and the agency gets their commission. But it works. In seven years, the country is the most accessible in central America already. It’s incredible to see how everything is being adapted.


Health Hats: You must be proud.

Juve Acuna: Yes, I’m proud. I learn a lot from these people. Sometimes people complain a lot about their life, and I took an excellent example from them. They always go forward, and it doesn’t matter if they have a disability. They want to do it, and they want to enjoy it.  That is a big lesson for me.

Health Hats: Yes, it’s inspiring. I call myself a patient-caregiver activist. Indeed, with my experience as a patient and a caregiver, I get so much inspiration from others. How they’ve managed, and their bravery. There are times I feel sorry for myself. Then I think, oh, here I am. I went on a suspension bridge in Costa Rica too. I’m proud.

Juve Acuna: You can do zip-line tours. You can go rafting.

Health Hats: Zip-line. I’ll text you, and we’ll set it up—next time. Somebody like me could do a zip-line?

Juve Acuna: Oh yes. People that cannot walk at all. They’ve done it, and they cry. I have people we take in the middle of the forest, and this lady was crying a lot because she never imagined being inside the jungle like that. Enjoy the canopy trail and enjoy the birds.

Possibilities, safety

Health Hats: What haven’t I asked you that I should have asked about travel and disabilities? What should we share with the listeners and watchers?

Juve Acuna: They can feel safe. People will take care of them. Hotels or tour operators already have the experience approved by the tourism board and our company. They’re in good hands. I’ve done tours with blind people. I’ve had people who cannot talk at all and blind people with different disabilities, some paralyzed in the second vertebrae down. The tour is entirely different in the middle of the jungle, just to hear things and feel textures. It’s another world. Wheelchairs, we have all kinds of equipment that they can enjoy here. We have special equipment to take them from the chair to the bed if they need it.

Health Hats: Wow. Thank you.

Juve Acuna: You’re very welcome. You’re welcome every time you come to Costa Rica. It’s been my pleasure. Thank you so much.

A word from our sponsor, Abridge

Now a word about our sponsor, ABridge. Record your healthcare conversations with doctors and other clinicians with ABridge. Push the big pink button and record. Read the transcript or listen to clips when you get home. Check out the app at or download it from the Apple app store or Google play store. Let me know how it went.

Photo highlights of the trip

Figure 5: Scarlet Macaw

Figure 4: Rio Fortuna Waterfall, Alajuela


Figure 7: Poisonous blue jean toad

Figure 6: Grey or Steel Iguana

Figure 9: Poisonous Yellow Pit Viper

Figure 11: Sloth

Figure 10: Volcano Arenal


Figure 8: Dozens of crocodiles sunning under Rio Tarcoles Bridge in Garabito


Figure 15: Humpback Whale, Manuel Antonio National Park

Swimming in the Pacific Ocean

Figure 12: Pacific Coast

Juve planned a half-day catamaran excursion off the Pacific Coast. He stayed behind. We saw an adult and child humpback whale. The crew supported me in walking across the boat. They fitted me with a life preserver around my waist rather than around my neck so I could float and swim in 80-degree water for almost forty minutes.  Again, terrified to swim, but unlike the suspension bridge, I felt completely safe in the water. Luxurious.

Figure 14: Sunset on Pacific

Figure 13: Holding the sun

Howler and white-faced monkeys

Figure 17: Howler Monkeys in Aguirre

Figure 16: White faced monkey

I spent twelve years as a back-to-the-land farm boy hippie in rural West Virginia, so I’m used to waking up to roosters. But Howler Monkeys at 4 am outside your window are deafening. Juve said they are the second loudest animal after the Sperm whale. White-faced monkeys are complete pests grabbing food off your plate in outdoor restaurants. Costa Rica allows no caging, taming, or killing of animals. No zoos. No culling monkeys.


Walking trees most impressed me. Under the tropical canopy, these trees have been known to move upwards of five meters a year, around fifteen feet, by putting down and cutting off roots as they seek precious sunlight. The adaptability floors me. Disability feels like an experiment in adaptability, especially traveling with disabilities. At least twice a day over six days, other guides would stop Juve, tell him about some clients coming in a few days with x disability, wanting to do y, and ask where they should go and how they should prepare. That’s an effective network.

Podcast Outro

Figure 18: Walking Tree, San Carlos

I host, write, edit, engineer, and produce Health Hats, the Podcast. Kayla Nelson provides website and social media consultation and manages dissemination. Joey van Leeuwen supplies musical support, especially for the podcast intro and outro. I play bari sax on some episodes alone or with the Lechuga Fresca Latin Band. I’m grateful to you, who have the most critical roles as listeners, readers, and watchers. See the show notes, previous podcasts, and other resources through my website,, and YouTube channel. Please subscribe and contribute. If you like it, share it. See you around the block.