spring 2010

My Journey with the Honduras Health Mission 2010

by Jan Douglas

From January 8-17 this year I joined twenty-three other members of the Diocese of Atlanta and North Carolina on a medical mission in partnership with “Las Comunidades Unidas” (United Communities) to an area near Choluteca, Honduras. “Las Comunidades Unidas” was formed in 1989 by six towns and villages with the goal of working together to obtain sustainability for their communities. For twenty years, medical teams from the Diocese of North Carolina have been invited by these communities each January to sponsor a one-week health mission at two sites within their area of southern Honduras. For the last decade, the trip has been organized by Priscilla Shows (Elizabeth’s mom!) at St. Stephen’s in Durham, North Carolina and joined by team members from St. Bartholomew’s, St. Julia’s and now All Saints’ and St. Philip’s in Atlanta.

Honduras is the second poorest country in Central America with over sixty percent of its population of seven million living below the poverty line. Thirty-six percent of its people are either unemployed or underemployed. Twenty-five percent of its children are chronically malnourished according to the World Food Program. Floods, hurricanes, soil erosion, land deforestation as well as ineffective and corrupt political administration have all helped to perpetuate poverty and malnourishment in the country. Health care in Honduras is a luxury that few can afford, and although there is a system of public health care, it is underfunded and poorly resourced. Rural areas often have access only to a small health center staffed by a nurse and to advice from local health promoters.

The Honduras Health Mission provides four services during its seven days on location: medical clinics, health education for health promoters, dental care (primarily tooth extraction) and hands-on training for health promoters. The health promoters are community leaders who have undertaken to gain a basic understanding of disease and health care and to help their communities deal with local health issues.

I traveled with other members of the Atlanta team to Miami where we met up with the rest of our 2010 team for the final legs of our journey to El Corpus, Choluteca, Honduras. The bus trip from Tegucigalpa to El Corpus is slow, traveling over progressively rougher roads through the very mountainous regions of southern Honduras. We were all glad to finally reach the homes of our hosts in the colonial town of El Corpus where we were warmly greeted. Many of the team members have stayed with the same families for years, and there were many joyful reunions before we all turned in for the night. The next morning, we all climbed into the back of a flatbed truck for the forty-five minute ride to Las Madrigales where the United Communities have their meeting center with its classroom and dormitory (which doubles as a clinic during our week there). The drive is beautiful through small villages in the midst of high mountains with beautiful tropical foliage. During the dry season, it is very dusty with lots of stops to share the road with buses, bicycles and motorcycles and children herding cows. Children would peek out of doorways and climb fences to shout “Hola, Gringos” as we went by.

On our first two days, we conducted training classes for approximately thirty health promoters who traveled by foot, bus and mule back to join us. This year’s topics were first aid, CPR, choking relief and recognition of preeclampsia in pregnancy (a topic especially requested by the promoters). Other years, training has been done in infections and antibiotic use, use of medical equipment such as blood pressure cuffs and otoscopes (which have been provided to the promoters), HIV/AIDS prevention and transmission, prenatal care, maternal health and newborn care and prevention of dental caries and fluoride application. An exciting project grew out of this last topic, which is application of fluoride to the teeth of the children of the communities twice a year. The fluoride is supplied to the communities by the mission, and the health promoters work with the local schools to get it done.

On our arrival in Madrigales the next morning, lines of patients were already forming and we all set to work. Besides myself, there were three other medical providers, several nurses, translators (fortunately my Spanish is now good enough that I was able to speak directly with the patients), pharmacy workers and people who worked with the Comunidades leaders to try to keep order. All sorts of problems were presented to me especially chronic coughs and asthma, dermatitis and skin infections, recurrent UTIs, “gastritis”, GI pain presumed to be due to round worms, inadequately treated hypertension and diabetes, chronic headaches and muscle and joint pain. A health promoter worked with me each day and we were able to learn from each other. Our ability to evaluate, diagnose and treat the problems we saw was very limited and this remained a source of frustration for me throughout the week. There were several very troubling problems for which people came seeking any sort of assistance we could give. I especially remember a thirty-eight-year-old woman who had a long-term, painful, ulcerating condition of her chest wall which we all suspected to be inflammatory breast cancer. She had been treated with various creams at the hospital in Choluteca and was unable to afford the trip to the capital to see a medical specialist. We were able to give toothbrushes, vitamins and analgesics to our patients as well as rudimentary treatment for their presumed conditions but nothing which would lead to long term decrease in their symptoms or control of their chronic health conditions. The work was exhausting; while the patients clearly appreciated our listening to their stories and our caring and trying to help them with our limited resources, I would leave each day wondering if there was some other way we could show our love and God’s care for these people that would have more lasting impact.

Our team was an incredible group of folks, many of whom who have been motivated to go back year after year to be in loving partnership and fellowship with our hosts and the hundreds of people who have been served by the medical mission. Many told me that the same patients come back each year and speak of how much they appreciate what the mission has done for them. Will I go back another year? Perhaps I will, but only if I can figure out ways to contribute to new directions for the mission which will promote more sustainable health interventions in the communities. I am left wanting to know more about the local “Centros de Salud,” what their needs and resources are, and how we might contribute to helping them meet particular health needs in the community. Perhaps we could take on supplying enough medication to really make a difference in hypertension in adults or asthma in children or figuring out what basic equipment they lack. Maybe we could invite the local public health nurses to work with us as a first step in understanding how to make our work more effective. There is already work being done by the mission to help coordinate a new food distribution program for some of the poorest members of the communities.

So, my journey was interesting and rewarding in the connections I made and in seeing and being a part of the love that was shared between so many folks who ordinarily live in such different circumstances. Affirming common joys, sorrows, worries and hopes with the people I met reminds me once again that we are all children of our one Creator God and that we must keep trying to figure out better ways to truly care for our brothers and sisters throughout the world. I have great admiration for the members of the Honduras Health Mission who go back each year to extend themselves in friendship to the people of southern Honduras and who each year keep trying to make the effort just a little bit more enduring.

Jan Douglas has been at All Saints’ with her family for the last six and one-half years, since they moved here from Denver, Colorado. She is married to John Douglas and they have four children, ranging in age from 16 to 37, and two grandchildren. She works as a family physician in a community clinic which is part of the Grady Health system.

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