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Danger! Violent crime! Poverty! These are just some of the words
often used to describe the current situation in Honduras. I must
admit that I, too, initially perceived the country in this manner
after learning that it holds the dubious title of the world's
murder capital. To add to my consternation, the U.S. Peace Corps
had just pulled out of Honduras due to its concerns about the
safety of its volunteers. Once there, I realized that despite my
concerns about safety and the truly destitute living conditions for
many in Honduras, the majority of the people were still remarkably
optimistic and content.
Growing up in privileged countries like Canada and the United
States, we often take for granted essential freedoms and the many
small everyday privileges we enjoy. Upon arrival in Honduras, our
group was immediately whisked away by heavily armed police and
military personnel in a large school bus to the compound that would
be our base for the duration of our stay. For most of us, it was a
very unfamiliar and an initially unnerving experience to be
escorted by heavily armed personnel wherever we went.
The following morning we had an early start to accommodate the
2.5-hour commute to the small village of Santa Maria. Upon arrival,
we noticed hundreds of families already lined up and waiting. As
soon as our group saw the overwhelming masses of people awaiting
medical care, we began our set up of the temporary clinic. In one
room, a triage station was set up while in another, the physicians
consultation room, then a dental room, and at the very end, a
pharmacy. Since space was limited, patients did not have much
privacy. It was the best that could be done under the
circumstances. The whole group was anxious to get started,
understanding our time constraints and the large number of people
who needed to be seen. We started seeing the first patients within
30 minutes of arrival.
All of the medication and medical supplies available to us were
donated and brought by our group to Honduras. This limited our
treatment options. Many of the patients suffered from chronic aches
and pains from repetitive work or arthritis. A simple dose of
acetaminophen or ibuprofen was sufficient to alleviate pain in many
cases. Sadly, many did not have access to these basic
Medically speaking, a large proportion of the patients had
chronic illnesses, such as hypertension, diabetes, COPD, and many
fungal skin infections. Surprisingly, in spite of the advanced
stages of some of their conditions, the patients were not very
concerned. They barely complained of pain even when we knew their
conditions had to be extremely uncomfortable. Instead, they were
simply grateful for the opportunity to see a physician and to
receive some medication to treat their conditions. Each patient
seen was given, at a minimum, albendazol to treat any parasitic
worm infections, multivitamins to combat malnutrition, and NSAIDS
for minor fevers and pains. Patients greatly appreciated receiving
these medications as it was either unavailable or unaffordable for
Some of the patients seen were young pregnant women expecting
their first child. For the majority of them, it was a unique
opportunity to receive any prenatal care. A portable ultrasound
machine brought to Honduras by our group proved to be a very
valuable resource in screening these women. They were able to see
their babies on the ultrasound, learn approximately how far along
the pregnancy they were, and know if their babies were healthy.
Unfortunately there was one pregnancy that was diagnosed with
placenta previa with full coverage of the internal OS. The doctor
and I knew that this pregnancy was high risk and that it may result
in death if the mother tried to deliver the baby on her own.
Fortunately, since the ultrasound caught this abnormality, the
young woman was advised to deliver her baby in the city where a
Caesarean section could be performed.
The ultrasound was a very valuable asset on the trip, and it was
used to diagnose a wide range of medical concerns. Many patients
with chronic abdominal pain were screened to ensure there was no
organomegaly. Some patients were diagnosed with epididymitis and
were given appropriate medical treatment. An infant with a motor
developmental delay was even diagnosed with meningomyelocele and
referred to a specialist in the city.
I was exposed to one patient for whom nothing could be done.
This was quite an eye-opening experience for me as a student. A
six-month-old baby girl had far advanced hydrocele. The diameter of
her head was already three times the size of a normal child her
age, and it was deformed. I realized that there was nothing that
could be done to save this child's life at this point, not even in
the United States. Had the baby been fortunate enough to be born in
the United States or Canada, a ventricular shunt may have been put
in at a much earlier stage. The shunt would have prevented the
gross deformity and may have prevented the mental retardation that
followed. In my mind, this particular case delineated for me the
differences between life in a poor country compared to life in a
rich country with available health care.
In spite of the sadness of some of the cases, the overall
benevolent nature of the trip made it worthwhile. It is a good
feeling knowing that we were able to make a difference, even if it
was small in some cases. In the course of a week, we managed to
visit two underprivileged villages and see approximately 1000
patients. It is a real privilege to grow up and live in a developed
country without fear for one's security, starvation, or lack of
health care, and it should never be taken for granted.
Rashmi Maraj Prashad
Windsor University School of Medicine
Class of 2013
September 2012 Issue of IMpact
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