Health Care in Honduras

Two weeks ago, one of the teenagers at the technical school foolishly tried to leap from one roof to another, and instead fell over twenty feet onto a cement sidewalk, badly injuring his head. He was taken to the emergency room at Hospital Escuela. Claudia and Lazaro went immediately to the hospital with the boy. I was able to contact Barbra McCune, a medical missioner from Diocese of Massachusetts, who dropped what she was doing in order to come with me to the hospital.

The emergency room environment in Honduras was new to me. Please understand that, as a parish priest for over 20 years, I am no stranger to emergency rooms or hospitals. But nothing I experienced in those years of parish ministry prepared me for the chaos and the concentration of human suffering I encountered at Hospital Escuela.

The emergency room was packed with people. Literally. It was hard to even walk through the room, without pushing against all sorts of folk in all sorts of conditions. We finally found our way to a tiny, four-foot wide, curtained alcove. Our patient, Carlos Corrasco, was placed on a narrow metal stretcher, where he would spend most of the next 24 hours, without benefit of mattress or sheets. He was bleeding from his head wound, and, at times, in his confusion, struggling to try to get up. So he had to be held down by those of us who were there with him. Nursing interventions and care by House Staff were minimal and only obtained after Dra. Barbra advocated for our patient

I learned some things about the healthcare system in Honduras. Tests are not done in the ER until paid for in cash. And bargaining is part of the process. Barbra was able to intervene when she found they were demanding of us 5 times the normal cost of a CAT scan. Latex gloves are not provided. Those who come with patients are largely responsible for their care. Patients without helpers walked through the halls holding their own IV's up with their good hand, since IV poles are not provided. An older woman lay curled up on the floor of the hallway. A patient who had died was left in the hall for several hours. Lazaro was asked to help hold a man who had been admitted with multiple gunshot wounds and was bleeding profusely. Sheets and towels are rare treasures. At one point, we obtained some sheets and took turns sitting on them in order that they not disappear. Later, I found myself holding both patient and X-ray plate without, of course, any radiation shield. There was no physician in charge overall. If Dra. Barbra had not been there, I wonder what would have happened with our young patient.

The whole scene reminded me of a Heironymous Bosch painting. Gunshot victims shared space with an extremely emaciated child obviously suffering from advanced stages of malnutrition. Families wheeled their patients around the corridors, hoping eventually to stumble on the unmarked hallway that housed the X-ray room. Outside, a large crowd milled around hoping for a chance to get in to see their loved ones. The people there had all the signs of ongoing poverty, including the lines etched into their faces by chronic suffering.

Human misery can take many forms. Sickness, pain, humiliation, emotional distress, discomfort, disorientation, abandonment - they were all present in that scene.

At one point, Barbra left to try to find one of the neurosurgeons. He had been assisting in a brain surgery, but took a break when the chief surgeon realized he was missing some important instruments, and asked this doctor to check and see if he had them in his office!

Surrounded by all that confusion and pain, a small community of compassion held together. Several of the El Hogar staff were there to help, and to comfort the boy's family members. Lazaro stayed the entire night. Barbra generously gave of her medical expertise, and also offered prayers. A priest from the diocese came to support us. Claudia later said that she had felt privileged to be able to serve God in that place.

After several days, we made the decision to have Carlos transferred to San Jorge hospital, where he received a private room and much more consistent nursing care. Barbra has continued to round on Carlos, and our staff have been faithful in visiting with him. Sunday, for the first time in 15 days, he was able to talk and respond appropriately to questions. We gave thanks that morning at Santa Maria for his striking improvement. We hope that he will leave the hospital this week.

There are times when I am able to settle into the world of El Hogar, with its order and joy and love, and temporarily lose sight of the conditions which make a place like El Hogar necessary. Spending a day in the ER was a stark reminder of the deep-seated problems that continue to plague Honduras, and the ongoing need for a ministry of presence and healing here.

Que Dios lo Bendiga,

The Rev. Rich Kunz
Executive Director
El Hogar Projects