Medical Mission to Honduras

Stanford I. Lamberg, MD

Disclosures

October 24, 2003

In This Article

The Mission

A mariachi serenade awakened us at 4 am on Sunday. Our group of 57 physicians, nurses, other medical personnel, and support staff had arrived in Honduras only the night before. Had one of the teenagers in the group kicked on a boom box? No, the hospital administrator had arranged this rousing welcome so that we would not be late for the patients he said would be waiting for us at 8 am. We stumbled out of our sleeping bags, ate a breakfast of red beans and scrambled eggs, and arrived at the hospital by 6 am. We hoped to unpack supplies for our week-long medical mission before the first patient showed up. By 8 am, however, a throng of 800 patients was waiting for us.

The mission, organized by the Episcopal Church of the Redeemer in Baltimore, Maryland, had made 4 previous trips to Honduras. The group had never included a dermatologist, although one third of the patients in previous years had reported skin concerns. Having seen the face of Central American poverty on a recent visit to Nicaragua, where my son is a Peace Corps volunteer, I was receptive to an invitation to join the Honduras mission. We spent 8 days in the country: 4 seeing patients in a hospital clinic in the town of Santa Barbara, 1 seeing patients in the mountainous rural village of Atima, and the other 3 either traveling or relaxing. Our group was quite ecumenical, with members from a variety of religions. Catholic Charities sent a container of medical items valued at $400,000, and most of us paid $1200 each to cover airfare and local expenses, but church funds were available for those unable to pay.

We arrived in Honduras on Saturday, June 28, 2003, after an early morning flight from Baltimore to Miami, a 2-hour flight from Miami to the chaotic small airport of San Pedro Sula, and a 3-hour ride to the outskirts of Santa Barbara in a yellow school bus with an armed guard standing in the doorway. We were housed in a single-story concrete block school, a series of large rooms opening onto a covered porch. Some of us slept on the porch to catch the breezes, but most slept in the concrete-floored schoolrooms, with air-mattresses and mosquito netting set up in tight rows. The bathrooms had flush toilets and cold showers. We ate at the nearby home of the local Episcopalian minister, whose wife and daughter, along with helpers, prepared our meals (Figure 1).

The outdoor kitchen. Photo courtesy Dr. Lamberg.

Honduras, located between Guatemala on the north and Nicaragua on the south, is about the size of England. About two thirds of Honduras is covered by mountains, and nearly half is forested. It has more intact rain forests than Costa Rica, Guatemala, or Nicaragua, but, as in these countries, its forests are threatened by loggers, coffee growers, and farmers.

Having spent a year in Danang, Vietnam, 35 years ago, I expected dermatologic complaints to be common. Skin disorders develop exaggerated forms in incubator-like tropical environments, especially when combined with unsanitary living conditions. In Vietnam, skin conditions were the third most common cause for the evacuation of American troops, superseded only by wounds and malaria.

Our group included 13 physicians: 2 primary care physicians, 1 rheumatologist, 3 pediatricians, 2 ophthalmologists, 1 pediatric orthopaedic surgeon, and 3 obstetrician/gynecologists; I was the sole dermatologist. The group also included a physical therapist, 10 nurses and nurse practitioners, a podiatrist, a podiatry school student, and a support staff, including the rector of the church, several chaperones, and 30 high-school and college students, many of whom spoke Spanish.

In previous years, the group worked exclusively at the rural clinic in Atima. This year, the staff shifted its efforts to Santa Barbara, a larger town with a hospital that served both the town and surrounding rural areas. The hope was that the medical staff could accomplish more in more sophisticated facilities, and could teach local and hospital physicians techniques to carry on the effort. This goal proved overly optimistic.

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