Honduras
A healthy blessing for Honduras
CATCAMAS, Honduras – “What am I even doing here?” It’s…
A mission of primary care
When a medical ministry built an impressive clinic in rural Honduras, some feared the government would take it over. Nearly two decades later, the ministry has experienced a takeover of a different kind.
LA CAMPANA, Honduras — A military helicopter landed in a soccer field about an hour from this Central American village 18 years ago.
As the whup-whup-whup of the propeller blades came to a stop, government officials in suits, including Honduran vice president Alberto Díaz Lobo, walked across the pitch and into the newly built Good Samaritan Clinic in the city of Catacamas for a ribbon-cutting ceremony.
Hondurans crowd around the helicopter that brought Vice President Alberto Diaz Lobo to the opening ceremony for Predisan’s Good Samaritan Clinic in 2003.
“I want to recognize all the humanitarian spirit that you must have,” the vice president told the assembly of Honduran physicians, ministers and representatives of Churches of Christ in the U.S. who had helped make the clinic a reality.
Related: A healthy blessing for Honduras
The facility was named for Jesus’ parable of the Samaritan, a man reviled by Jewish society who nonetheless showed mercy and provided healing for a Jewish man in desperate need. The new clinic would operate under Predisan, a medical mission that takes its name from the Spanish words for “preach” and “heal.”
Lobo marveled at the 20,000-square-foot clinic, complete with surgical and dental suites. There was little else like it in all of Olancho, a rugged, mountainous state in eastern Honduras, home to more than a half-million souls. Yet one public health official, Dr. Mirna de Lobo, challenged the Christians to “make this project bigger.”
“We have the dream,” she said, “that the people in public health are going to learn to give the quality of care that the people of Predisan are giving.”
Some of the U.S. supporters began to murmur. Had they made the facility too nice? Would the health officials designate it as a community hospital? Would the government take over? What about the ministry’s spiritual mission — to provide care and improve lives, opening doors for the gospel?
As he glanced at the clinic’s newly painted walls, Vice President Díaz Lobo told the Christians to “take really good care of it. Don’t let it deteriorate.”
New clinic … so what?
After the ribbon cutting, life didn’t change much for the people of La Campana, including Emerita Duarte. The Good Samaritan Clinic was 35 miles away over mountainous, gravel-and-dirt roads that become impassable when it rains.
Duarte is Pech, an Indigenous people who have lived in Olancho since the early 1800s, were forced by Spanish colonists to leave their homeland on the island of Roatán.
Despite the Presidan clinic, Pech people including Emerita Duarte, 75, had limited access to reliable care.
They speak in patches of their ancient language and Spanish. Like many Indigenous peoples in rural Central America, the Pech have limited access to health care.
A small, government-run clinic is just a short walk up a hillside path from Duarte’s home, but she rarely went there. It had one staffer, irregular hours and little in the way of medications.
If she needed a doctor, she had to walk nearly five miles to wait in a long queue at the main clinic in Culmí, about five miles away. The rugged trek took at least 90 minutes. To be seen, she had to leave at 4 or 5 in the morning, she said.
The lack of resources took a terrible toll on old and young alike. Despite having a network of 17 rural clinics, the Culmí municipality had the highest rates of maternal death and infant mortality in the country.
Workers from Predisan made mobile medical trips into Culmí and referred some patients to the Good Samaritan Clinic. But the lines at Culmí’s clinic kept getting longer.
The situation was deteriorating.
Not the takeover they expected
That changed in 2014, when the Honduran government approached Predisan about using the ministry’s resources to provide better care for the people of Culmí.
It wasn’t the government takeover that the U.S. Christians had feared when the Good Samaritan Clinic opened 11 years earlier.
“We have something in common with the government. We provide services to the poorest of the poor. We have the opportunity to provide the love of God with our actions.”
It was, in fact, quite the opposite.
Through a process called “decentralization,” the Honduran health services turned administration of the rural clinics over to Predisan, empowering the ministry to act as primary care for the Culmí region. The ministry brought in new staff with funding from the Bill and Melinda Gates Foundation. Predisan also used its own funds to bring in chaplains for the clinics.
Frank Lopez
“We have something in common with the government. We provide services to the poorest of the poor,” said Dr. Freddy Juárez, a physician who coordinates five of the clinics for Predisan, including several in Pech communities. “We have the opportunity to provide the love of God with our actions.”
The transition wasn’t easy, said Frank López, a registered nurse who serves Predisan as healthy communities director.
“People in Culmí had a culture of not going to the doctor, and when they went, it was closed,” he said. “People wouldn’t treat them well. So we had to start our job from zero.”
Maps, push pins, bread and fish
Predisan assembled “family health teams,” including those who speak Pech, to visit villages and talk about disease prevention and nutrition. In the clinics, workers put up detailed, hand-drawn maps showing the locations of homes, marking families with push pins. Soon, the walls were lined with graphs charting the prevalence of maladies like dengue, zika and COVID-19 in their communities.
At a mountainside clinic in El Cerro, Honduras, Predisan worker Dennis Santos shows a map with push pins denoting the locations of families the clinic serves.
Staffers launched a “Madre Estrella” (“Star Mother”) program that encourages women to get regular checkups, take prenatal vitamins and undergo screenings for cervical cancer, one of the main causes of death for mothers in Honduras.
During a recent visit to the main clinic in Culmí, coordinator Eblin Gómez produced detailed graphs and pie charts showing recent declines in maternal deaths and infant mortality. Parents now bring their children in for regular checkups and ask for immunizations, Gómez said.
That wasn’t the case 35 years ago, when Predisan began working among Honduras’ rural communities, said Amanda Madrid, the ministry’s CEO. Back then, she said, “they came after me with machetes.”
The work in Culmí has garnered international attention. Dr. Hugo Godoy, a health official with the Interamerican Development Bank, the largest source of development financing in Latin America and the Caribbean, praised the work of the family health teams, which has reduced the prevalence of childhood ailments including pneumonia.
Color-coded folders, divided by communities, hold the medical records of families served by the El Cerro clinic in the Culmí municipality.
More impressive, Godoy said, is the “incredible love for others and positive attitude” shown by healthcare workers to the poorest in their communities. In Predisan, “the Ministry of Health and the population have incorporated an excellent partner,” he said, “with Christian values and principles.”
A delegation from the Dominican Republic traveled to Culmí to see the work as part of the Mesoamerica Health Initiative, an endeavor to improve care across the region with funding from local governments, the Bill and Melinda Gates Foundation, the Carlos Slim Foundation and the government of Spain.
“Their ability to do so much with so little recalls the biblical miracle of the multiplication of bread and fish.”
Dr. Luz Herrera, assessor of maternal and child health for the Dominican government, was ”pleasantly impressed with the high standard of quality, neatness, efficiency and order of the service that Predisan offers,” she said.
“Their ability to do so much with so little,” Herrera said, “recalls the biblical miracle of the multiplication of bread and fish.”
‘The Christians treat everyone the same’
The turnaround couldn’t come at a better time, said Dr. Cruz Barahona, who works in the Culmí clinic’s maternity ward. In the midst of the COVID-19 pandemic, the region is experiencing a baby boom. Barahona had little time to talk. He’s averaging 16 to 18 ultrasounds per day.
Many women must travel for hours, across creeks that become impassable in heavy rains, to reach the Culmí birthing center. So Predisan improved the clinic’s onsite facilities for pregnant women and their families to await their children’s births. Chaplains make regular visits and pray with the families for healthy deliveries.
Left, grandmother María Isabelle Anariba prays at a dormitory in Culmí, where her daughter is soon to deliver. Right, a mother-to-be waits to deliver at a dormitory at a clinic in Catacamas.
“The Christians treat everyone the same. They’re united,” said María Isabelle Anariba, a 56-year-old who was awaiting the birth of her eighth grandchild at the Culmí clinic. “I see that, and I’m very grateful. They love everyone the same.
“I have been treated for high blood pressure here,” she added. “I know how they treat me. I feel like they care about our health.”
House calls and prayers
Back in La Campana, the small clinic up the hill from Emerita Duarte is now fully staffed and has regular hours.
Still, she rarely goes there.
They come to her.
On a recent Tuesday afternoon Dr. Freddy Juárez made a house call, checking Duarte’s blood pressure and asking her about her medications. Standing nearby was Leopoldo Duarte, an auxiliary nurse who’s not directly related to Emerita but is a member of the Pech community.
Leopoldo Duarte serves as an auxiliary nurse at the La Campana clinic.
He taught a group of visitors a few Pech phrases, including “akaparkagua” (“thank you”) and one that sounds like “in kara kaisa” and basically means “how are you doing?”
Leopoldo Duarte has worked at the clinic for 11 years and was its sole employee before Predisan took oversight. It was a lonely job, he said, and he didn’t have anyone to train. Now the clinic has desks, chairs and a better record-keeping system. Nurses and physicians are here regularly. A chaplain comes to do devotionals daily. If he can’t make it, the staff does its own devotionals.
Dr. Freddy Juárez takes Emerita Duarte’s blood pressure during a home visit in the community of La Campana, Honduras.
“That’s the main thing,” Leopoldo Duarte said of the spiritual focus. “That is what we should be doing in the first place.”
Emerita Duarte, now 75, agreed. In addition to the medical house calls, she gets regular visits from Predisan chaplains — and regular prayers. In faded letters scrawled across her abode wall are the words “Dios es amor” (“God is love”).
“That’s very important,” she said, glancing up at the words. “We can’t do anything without God.”
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