Notes from Honduras II

Feb 09 2009 Published by under Medical Musings, Notes from Honduras

In 1999, during my intern year, Hurricane Mitch struck Central America. As stated below, I wanted to become involved. The program director of my residency was kind enough to view this as a worthwhile educational experience. This is part II of my diary from the trip. Part I is here.
To Juticalpa
As we left Teguz, we crossed one more bridge and began to climb into the hills that surround the high valley in which rests the city. Thin dogs wandered along the roadside sniffing at the animal skulls lining the road. Women and children crowded into ravines to wash clothes in the river which was both life and death for the people. We stopped briefly at a bakery for a snack and some Cokes and got on the highway for Juticalpa, and oddly normal act in this profoundly odd environment.
The road is one of the best in the country, and one of the few paved roads outside the main cities. As the road winds into the mountains, the air becomes cooler and fresher. We could see ahead the unusual mountains that dominate the geography of Honduras. It looks much like Napa or Sonoma in northern California. The mountains are low and steep, and crowd together as if vying for space in this small country. Pine trees and clouds cling to the hillsides, which are dotted by mud shacks with red-tiled roofs. Cattle and horses graze lazily. As we enjoyed the scenery, we came abruptly upon a line of rocks across the road indicating a detour. The river had washed away a bridge ahead.
To digress briefly, the most damage from the Hurricane came not from devastating winds or sudden violent storms, but from the long, steady rain that continued for a week as Mitch poured the warm Caribbean water onto the loose soil of the mountains. Water poured down the sides of the mountains and found the beds of the normally tranquil rivers. The rivers rose quite suddenly. The mountain people and campesinos are experts at reading the rivers and moved to high ground as the rain fell. The city dwellers had no such knowledge and died in large numbers as flood waters carried them away in their homes and the mud entombed them. Many of the health problems related to the storm stemmed from contamination of the water, and the isolation of communities by the destruction of bridges. There are very few areas that can be reached without river crossings.
I had long since climbed from the bed of the truck and into the cab with my driver Rolando. He spoke only Spanish, and I only English, but we conversed a reasonable amount. We turned onto the dirt track that served as the detour and crossed the river on a makeshift bridge that had been finished only a few days before. It was very rough, but afterward we rejoined the main paved road to Olancho. About 2 hours later, we rode into Juticalpa as the sun was setting.
Juticalpa is a small city and is the capital of a large cattle and farming region. Like many Latin American cities it has a main square and a large church. We pulled up to the church and Obispado (Bishop's residence) and unloaded our gear. The Obispado is about 50 years old and built in the old Spanish Colonial style, an inner courtyard lined with an esplanade from which one enters the individual rooms. The Obispo himself is an Irish American from Boston, a very congenial and hospitable man. The cooks keep him fed with pretty traditional American meat and potatoes, so we sat down every night to unremarkable fare, although one night we had some traditional smoked ham from Olancho, and another night we had a traditional Honduran chicken soup. We were very well cared for. The rooms off of the courtyard were simple and comfortable, with two cold water showers, one each for the men and the women. There was also a lounge with a well-stocked fridge and liquor cabinet and satellite TV where we could gather and share beer and stories.
There were a remarkable variety of people down there to take part in relief efforts: EMTs, nurses, doctors, most of them very enjoyable people to spend time with. We were all divided into teams and given assignments for the week. My "go" team included Ty, Kim Marie, a nurse from Nashua, and Magda, a young woman from Juticalpa who would serve as our interpreter. Magda was clearly from one of the wealthier families in town; she attended the English School, wore American-style clothes, and lived in a neighborhood with cobbled streets instead of dirt tracks. She lived with about 9 siblings and their families. There was much confusion among our group as to here actual first name; it was unclear whether is was "Magda" or "Mauda". As it turned out, her mother had named her "Magda", but it had been written incorrectly on her birth certificate as "Mauda". Her family could not afford the fee to make the official change.
That evening we went to the bodega where the supplies were stored, pooled our resources, and put together supplies for the next day. Our group would be heading out to the village of Zopilotepe ("Village of the Vulture"), the bridge to which had been rebuilt about three days prior to our arrival. No one had been out there yet, and we did not know what to expect. During our briefing we were informed that we would be serving as public health officials. Normally, Honduran medical students spend a year of service after graduation in the outlying clinics, but this year had seen a very small graduating class, an unfortunate coincidence in this time of need. The Bishop had offered up our services to the health department as fill-ins. It was not well know what the road conditions would be, so we rose quite early the next morning to set out to our assignment.
Next, Zopilotepe; the Clinic

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