Back to Work

It’s 4:30 in the afternoon and I feel like a slab of bacon lying on a rock in the desert. The Hurricane passed and with it the cool weather. It had been so cold I was sleeping under my clothes layered over me like a blanket. The people here are not used to that kind of weather. In the end we had a load of rain but no major winds and no major mudslides. The government called it a national emergency and closed up the country in preparation. We were lucky because just like Haiti, there is no infrastructure to support a major storm. In October of 1998 Hurricane Mitch developed as a tropical wave in the Carabean Ocean and quickly grew to a devastating storm the crushed the coast of Honduras. Half of the mountain above Pena Blanca collapsed and washed out hundreds of little villages, killing thousands of people. The city of San Pedro was flooded and many people drowned. At that time there was a bit of warning and the government tried to evacuate cities and villages at risk but residents were afraid of looters and they didn’t want to leave what little they had. Honduras has yet to recover completely from those losses.

Now that the rain passed it was busy day in the clinic. Typically we see a great variety of illness some we can treat and inevitably some we can not. Today we ran the gamut from minor aches and pains to major social atrocities. One has only to listen for 5 minutes passed the chief complaint to get to the true illnesses behind many of the presentations. As I have said before, in this society it is very male dominated with woman having so few social rights. We are treating a few HIV patients and sadly enough the women do not feel they have the right to protect themselves from getting the disease. There is a feeling of powerlessness to rebel because of a lack of self worth combined with the economic constraints associated with the risk of single parenting. But that is not all, even deeper rooted in the social structure, there seems to be a sense of moral obligation to support the man’s wishes, even though they recognize it is a life threatening situation. There seems to be a similar situation in India which is leading to world health crisis as the number of HIV patients sky rockets daily. The awful part of the whole mentality is that a man with HIV is not shunned, but once a woman becomes positive…..they are worthless.

We are also still fighting the battle against TB. Right now the government still has no funds to treat the disease appropriately and resistant cases are popping up more and more frequently. We had a man today for which the health department did not even try to treat. We don’t have the resources to treat him either. Our hands remain tied in every way possible. We can only educate on how to prevent the spread of the disease. As you can see public health is equally as important as medical therapy.

We are meeting with the local doctors this week to discuss the pooling of resources. Hopefully we can develop a more effective medical model for the region. I recognize that to some this seems like a pipe dream, but if no one ever dreams it how can it come true…….