I write this post at 38,000 feet on my return home from a surgical mission to Honduras. This was my ninth trip to a surgical hospital in Guaimaca, Honduras, and we had a fantastic week. Performing 19 head and neck surgeries in 4 days, our teams of volunteer doctors, nurses, surgical techs, medical assistants and anesthesia providers were able to make a big impact on the lives of these patients and their families. Many of the U.S. team members, Honduran nurses, missionaries and translators have become my good friends over the past decade. The surgeries we performed included thyroidectomies, cleft lip revision, reconstructive rhinoplasty, sinus surgery, tumor removal and others.
During some downtime mid-week, I came across the story of a boy and his uncle who were exploring the wildness of the Mississippi River Delta together. They ventured out one morning, only to suddenly realize they were surrounded by quicksand, sinking and incapable of saving themselves. The following day, a search and rescue team came upon the boy, almost entirely submerged and barely conscious. After successfully reviving the boy, the team asked him if he knew the whereabouts of his uncle. The boy’s eyes grew wide as moments from the previous day flashed before him. He looked up at them and said, “I am standing on his shoulders.”
By providing medical and surgical care to those around the world, what our group and many others like it aim to do is lift up and potentially save the life of each patient that we treat. We travel to Honduras every summer in early August and are always looking for doctors, nurses and surgical techs interested in surgical mission work. Email me directly or submit a form through our website for more information.
I will leave you with an article written by Naa Dromo Korley, a pre-med student at The Ohio State University. She spent time shadowing me this summer and is a talented young woman with a very bright future. In the article below, she does a great job summarizing the healthcare system and its challenges in the country of Honduras.
Stephen Nogan, M.D.
Columbus Facial Plastics
“Medical Disparities in Honduras”
By: Naa Dromo Korley
Many countries face health care disparities whether it is due to the lack of access to medicine, access to surgery, or even access to health insurance. But, the healthcare in Honduras has been deemed the worst in Central America according to the Willy Brandt School of Public Policy. In Honduras, access to health care is determined by poverty level and location. 66 percent of the population live in poverty, with one in five people living in extreme poverty (Eppenauer). The healthcare system is divided into two sectors: public and private. The private sector provides access to health services, but the expenses are paid by the patient, whereas the public sector includes organizations such as the Ministry of Health and the Honduran Social Security Institute. According to research, approximately 90% of people living in Honduras do not have health insurance which forces them to rely on the public sector for healthcare. It is disheartening to see how many people in Honduras have no access to health insurance. 90% of the population in Honduras live with health conditions that could be potentially fixed with efficient healthcare, but no one can afford it.
Healthcare should not be based on whether one has the financial ability to afford it. Healthcare is a necessity that many people living in Honduras lack. The CDC reports that there are around 0.37 physicians per 1,000 people in Honduras. For those citizens of Honduras lucky enough to have healthcare, they must often walk for days to the nearest hospital in Tegucigalpa. Many people avoid going to the hospital due to these barriers and instead rely on alternative types of medicine such as plant medicine, shamans, and other non-traditional remedies to treat medical conditions. Ongoing research has found that the Pech people who were previously known as the Paya were fond of using plants for medicinal treatments. An ethnobotanical study was conducted at the Santa María del Carbón community in north-central Honduras which led to the results that 68 plants in total are used for medicine, 40 other plants are used for food, 23 plants in the region are used as sources of wood, 8 are used for beverages, 7 are used in artifact manufacture and 10 are used in other ways.
Even though a small percentage of the citizens in Honduras have gained access to modern medicine, many still rely on traditional healers such as the Shamans or curanderos. Shamans are specialists who have sacred knowledge to communicate to those in sacred places which is why many people go to them first for treatment. They position themselves as sole intermediaries who have a direct connection to the supernatural and can cure illness. Curanderos, a Spanish word meaning healer, are first responders in treating snakebite victims which are often fatal in Honduras. Remedies for snakebites are usually warm baths in herbal plants that focus on cleaning the wound. Curanderos and the Shamans accept fees and gifts as payment for their ministrations which are usually in installments. If a patient dares to miss one installment the healers have the right to end their care at that very moment. A google search of “What to do when you get bit by snake” immediately talks about calling 911 or rushing into the hospital, but who is going to walk for 6 days or more to the nearest hospital? If you do not have healthcare in Honduras and are not within close distance of a hospital, your options are limited. Most people do not have enough money due to the low income they receive from their jobs, so going to a Shaman or Curandero is not even an option. This leaves them to attend to the snake bite themselves.
Although fatal snake bites are more common in Honduras than other parts of the world, the top diseases in Honduras are actually diabetes, cerebrovascular and ischemic diseases, lower respiratory diseases and Malaria. When it comes to surgically treatable conditions, people from outside of Honduras often see one surgery standing in between health and illness, life and death. But, to the citizens in Honduras they do not see just “one surgery.” They see unbearable finances, the long distance, the lack of accessibility to medication after surgeries, and much more. In Honduras, every three minutes a child is born with a cleft palate, and according to data from Operation Smile, as many as 93 percent of children who have unrepaired cleft conditions die before their 20th birthday. This data and these conditions will never improve if people with power and resources do nothing. As Mother Teresa said, “I alone cannot change the world, but I can cast a stone across the waters to create many ripples.”
Naa Dromo Korley
The Ohio State University