Communication barriers
The major problem they had was one of communication. Alvarenga was asking for a doctor and for medicine, but the couple spoke English and he only spoke Spanish. Resorting to drawing pictures to try and explain his story, in the end, Alvarenga burst out laughing at the absurdity of the situation and his rescue.
He was saved, after 438 days he had found people, dry land, food, and water. He knew how unlikely that was after all this time. Now he just needed time to recuperate and medical help for his broken body. He was hugely grateful to the couple.