Health in Honduras

During training the hierarchy of the Honduran health system was thoroughly drilled into our heads. Now that we're at site, seeing it in action at such a local level has been really interesting.

In our municipality there are approximately 10,000 people and 2 doctors. Therefore, the health center and NGO I work with have teamed up to recruit a group of community volunteers in 24 villages around the municipality who act as representatives and community health educators. These volunteers come in once a month for a 4 hour meeting, which includes information about upcoming health programs at the center or various villages (ex. lectures/activities on nutrition, hygiene, diarrhea, dengue, malaria, etc...), what health related issues have arisen in each village, and receive a short informal health session on various topics, which hopefully they will pass on to other leaders in their community. The goal is to create a domino effect that will reach many more people than just those who manage to come into the health center.

I went to the meeting last week and was thoroughly impressed. It's not a perfect system, but these volunteers clearly care about their communities and are eager to learn themselves. My counterpart managed to program 24 events in the next two months during the meeting, and we'll be giving nutrition and child illness prevention classes to mothers in each of the 24 communities (who hopefully will then pass on this information to the other women in their communities).

A few Honduran health stats if anyone's interested (I work mostly with women and children, so these stats favor that demographic):

• There is both a public and private health system in Honduras
• At the local level, there is usually 1 public clinic with a doctor per municipality, and several smaller clinics with a nurse. If someone needs to go to the hospital, they must travel to one of the 18 state capitals or the national capital. I believe there are only 3 private hospitals in Honduras, but I could be wrong.
• There is no such thing as an epidural in a public hospital here… (eek!)
• It costs 20 Lempiras to give birth in a public hospital in Honduras (or $1.06 USD) or 40 Lempiras ($2.11 USD) if a cesarean is required. (70% of the population in our municipality lives on less than a $1 a day/18.95 Lempiras)
• Despite this low cost, 70% of women in some aldeas still give birth at home with the help of a mid-wife or family member. A few reasons why: Many roads leading out to villages in remote or mountainous areas are virtually impassable during the rainy season. Some locales are hours from the nearest road, and the path leading to it is sloped, rocky, etc… And of course there is the fear that they won’t make it to the hospital and will end up giving birth on the local bus (think school bus). Or, this is the 10^th child and they don’t see the need to go (some will go to the hospital for their first child, then for none of the others).
• Midwifery here is a bit of a touchy issue in Honduras. The Ministry of Health is trying really hard to have all babies born in hospitals to bring down infant and maternal mortality rates. I think one issue is that some midwifes have been properly certified, whereas the knowledge has just been passed down generation to generation in some situations. We visited a hospital in La Paz where 3 newborns had just arrived with sepsis (their umbilical cords had been cut with dirty knives). To make hospital births more inviting, they've started a program to utilize midwifes as promotors for institutional births. If a midwife can get a pregnant woman to all of her checkups (there are usually 3-5) and to the hospital (arranging a ride, etc…) they get a stipend, which offsets the price they would have requested for delivering the baby.

Anyway, that's a little summary... I'm really looking forward to these classes the next few months and meeting so many people. The more friends we can make, the more opportunities we will have to help. Sounds a bit cheesy, but that's the way it works here. Plus, getting to go into the mountains each day is amazing!

Have a good one!

Lauren