Tuesday, January 13, 2009

More Adventures/Thank God for Spanish Speakers

To start with- I'm all better. I got over the death cold sometime last week and all of the staff has had a little bit of rest, therefore making the entire apartment a much more pleasant place to live.

So yesterday was my big trip to Ceiba- a town about three hours away by bus. It's best known as the crossing city to Roatan (the gorgeous islands that are the reason that people visit Honduras). However, outside of the city is a clinic known as Salud Totale (Total Health) that is a big deal because it is partially sustainable (i.e. paid for by the clients). The clinic is made up of dental, medical and opthamological practices mostly run by brigade. It has one full time doctor who sees about forty patients a day, a pharmacy, and counseling run by the church that it is a part of. It is pretty heavy on religion as it is based from the congregation of a local church and funded by US churches. More on that later, because the adventure getting there is a story on it's own.

I woke up early so that I could catch a bus to Ceiba and be back in El Progreso by nightfall. Josue, one of SHH's Honduran employees, went with me as a bodyguard/spanish speaker/company. We got on a really nice bus to Ceiba and I learned the usefulness of the past tense verb "fui" (it really is useful to add another tense to vocabulary). I also learned that "retournar" is to make a U-turn, and that "regresar" is to return. Not knowing Spanish is probably one of my top-three greatest frustrations ever, or actually, it was... until we actually got to Ceiba.

I had previously made contact with the clinic administrator, a very nice English speaking Honduran named Merphran. He had assured me that there would be a truck that would pick us up from the bus station and take us to the clinic because it is "a little ways away from the city." I started calling his cell number at 7:30am- a fairly normal time here, since the sun is up around 6:30am. I called just about every half hour until we arrived in Ceiba, at around 10:30am. As my luck would obviously have it, he didn't pick up. Having already wasted a week waiting for a response from a Honduran doctor, I was not in a very good mood, to say the least. There was no truck, I didn't know where we were in Ceiba (the bus stop turned out to be a random Shell station by a megaplex- not exactly the center of town), and, worst of all, I hadn't magically learned enough of the language to be capable in the situation. I called Alex, our Chief Operating Officer for other phone numbers to try, but none of them were answered. He made the wise suggestion of "lunch" (remember, it's 10:30am) so Josue and I ended up in KFC, eating terrible fried chicken at a very early hour. Short sidenote: KFC and Popeye's are super popular here because fried chicken is an extremely common Honduran meal. Also, rice and beans are served as a typical side. Back to the story: I was frustrated to an extreme- I had planned a foolproof excursion, it should have been easy, I had followed everything to the letter (as much as it could be in Honduras, where there are no regular bus schedules) and yet nothing had gone according to plan. We finished our fast food brunch without receiving a returned call from Merphran. Josue came up with some sort of plan- I'm still not exactly sure what it was, but we ended up in a taxi, headed towards the center of town. We got to the center, asked around for where Salud Totale was and no one knew. I was becoming more and more anxious and angry at myself as this occurred. Josue dragged me around, making sure that I didn't get hit by cars or get into any trouble. We got a lot of looks- there's not a lot of gringas walking around with Hondurans. We finally ended up in a pharmacy, where Josue got exact directions to what may or may not have actually been the clinic. We got in a taxi, I prepared to spend an insane amount of money, and we were on our way towards some clinic when, thankfully, Merphran finally called. We hauled out of the taxi about thirty seconds after getting into it (the poor taxi driver looked a bit confused) and ended up sitting in a park waiting for the promised truck. I noticed that the park was built by a Rotary Club and it didn't look very old- probably a remanent of work completed after Hurricane Mitch.

The truck showed up after about twenty minutes, and we actually had a twenty minute drive outside of Ceiba to get to the clinic. It's located in a residential area in the suburbs, high on a mountain, on land donated for tithe to a church. From the top, you can see the sea (it was pretty cloudy and grey when I was there, unfortunately). The complex is composed of the clinic (which eventually may be a hospital), a nutrition center (where sponsored children receive lunches and school help), offices and a massive church. The drive to the top of the mountain was fairly extreme and was a dead ringer for some of the roads in Rwanda (maybe a little nicer). Apparently, all of the land, when donated, was undeveloped. The church, in creating their complex, had to get electricity, access, water, everything fairly far up the mountain.

The clinic is a labor of love for the church. Hondurans started the clinic after Hurricane Mitch. It began as a stable location for occasional brigades to come in and do work. Now, with a full time doctor, nurse, and pharmacist, it provides continuous health care to a patient base that comes from hours away. Funding is provided through churches and private donors in the US. They have surgical brigades for complicated surgeries, an on-site x-ray machine and part time x-ray tech, a part time dentist, and optometrist brigades. When medical brigades arrive, the clinic can see up to 400 people in an extremely short time. When covered by regular staff, the daily patient load is approximately forty.

As seems to be the general consensus in Honduran health care, hypertension and diabetes are the major chronic issues that the clinic sees. In order to keep down repeat visitors, a visit to the clinic costs about thirty lempiras, or about a dollar and a half. This money barely covers the operating cost of electricity. The dental clinic, however, is completely sustainable and makes enough money to cover its own costs.

The clinic is missing many components that I, and the others interested in this project, consider vital. It is missing the vital link of community health workers and educators. Though it does provide birth control, an awesome step for a Christian organization, the clinic does not do sex education in the schools or in special camps. Nutrition education is also a vital part of child-raising and is something that many mothers miss. Additionally, not really related to the clinic but still interesting, the church performs house-building services for families that need them most, and provide the houses to the family without sweat-equity labor or a small fee. This type of service has been generally ended in the US and through US based NGOs, but apparently still exists in Honduras.

There's a lot more information on the clinic that I can give, but I'm pretty sure that it's only interesting to me. The trip back was uneventful. We got back in time for dinner and I got to meet the VA Tech team and the rest of the WM team that arrived yesterday. The teams are great and it's going to be a fantastic week. I'm going out to the work site tomorrow morning and getting in contact with some of my leads in the afternoon. Hopefully the rest of the week will be highly productive and I can get some serious work done on my project- at least enough to make it really cohesive.

Three days left- it hardly seems real.

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