I found this article very relevant from this travel blog: http://secretsofpanama.blogspot.com/
All Paradises have their downside
We have created this fact sheet based on our own experience, we believe important to share the reality of the small postcards islands with white sand, beaches and palm trees, prior departure, for you to enjoy better your trip and know exactly how it could be.
The San Blas Islands are run by the indigenous called The Kunas. They have their own rules and Panamanian law doesn’t much exist. Their main income is the tourism and foreigners are not authorized to operate tourisms there. Meaning this, as soon as you embark on their small boats, you are in the hands of the Kunas and it will be difficult to claim back any delays, logistics problems or refunds.
It is the reason why it is important to stay on recommended islands and not book through agencies with +10 islands listings who care about profit and not about customer satisfaction. Additionally, all these listings create confusion to travelers and hesitation. Now, you can also book your Party Cruise expedition to San Blas with pumping music on the boat, drinks all day bringing bad influences to the Kuna people which is probably not what you are looking for ?
Remember all islands are beautiful in San Blas and your choice should be determined by the most beautiful islands out of the 365 islands but on the Kuna Family hospitality, the accommodation, the service and tours provided. That’s why on our side we can only recommend the cabins of our friends located in Chichime Island and Diablo Island.
To explain the “low” service level sometimes offered, you must understand that San Blas is still very basic. The Kuna operating there have not all studied Hospitality Management, Logistics, Gastronomy, nor Tourism. There has been a big “boom” during the past years and they have not been trained for that and some just want you to experience their lifestyle in their own comfort which is as well part of the trip.
About the 4×4 road transportation performed by Panamanians, you can except to be a little squeezed as 7 passengers can fit into the car. As well, you can experience some delays or the car already waiting for you because the pick-up route can change and sometimes others passengers create themselves the delays (alarm clock issues). To avoid that, you can always pay extra fee and request a private charter.
Be flexible! You must expect some delays, lack of communication, waiting for someone or something without knowing the cause, rustic cabanas, no fish but pasta, (Yes!, sometimes the fish season is low), fried eggs and bread for breakfast, but in the end, everything works out if you can accept the little discomfort. Simply enjoy the adventure!
San Blas have a problem with rubbish collection, so you can expect to see some of it on these islands and more during summer season because of the strong current. The main rubbish are coming from the sea, cargoes and sailing boat!
Mandatory items you must take with:
Always have your Passport with you and not in your bag as there are some check-point on the way.
The 4×4 transportation will stop on the supermarket but at in case it does not, make sure to have at least a gallon of water with you and others small snacks.
Towel, swimming and snorkeling equipment
Rain coat for the boat ride
Ziploc or any hermetic bags to put your valuable items in a safe place during the boat ride as everything can get wet
Mosquito repellent (mosquitoes are not much present on the islands but at the port)