Covering COVID: Inside an ICU
JUTICALPA, Honduras — “It seems like an unnecessary risk,” one…
JUTICALPA, Honduras — Carlos Rivera didn’t seem to understand the question: “How does it feel to walk into a room full of COVID-19 patients?”
“I feel OK,” he said, looking slightly puzzled. “I pray with them.”
Perhaps it was a translation error — or the layers of personal protective equipment he was sweating under on this humid Honduran afternoon. So a Christian Chronicle reporter asked it a different way: “Why are you willingly going in there? A lot of people wouldn’t.” A bilingual physician, Javier Franco, translated the question into Spanish.
“They need prayers. Each patient in there is asking for prayers.”
Rivera’s answer was the same: “They need prayers. Each patient in there is asking for prayers.”
That’s all the motivation Rivera needed to strap on a hooded gown, hairnet, rubber gloves, goggles, an N95 mask and a face shield outside the Hospital Regional San Francisco’s COVID-19 ward.
He’s one of a small group of chaplains who take turns visiting patients in this Central American town — beset by poverty, natural disasters and now the virus — through Predisan, a mission with roots in Churches of Christ.
Stepping across the threshold into what once was the hospital’s emergency room, Rivera and a small team of physicians and journalists were suddenly in a landscape of labored breathing. On beds lined with beeping monitors lay the unit’s most critical patients, their faces obscured under masks and tubes.
Rivera made his rounds, taking prayer requests from those able to speak. His goggles fogged with condensation as he began to petition God on their behalf. A few patients responded, raising their arms, weakly, toward heaven.
“They asked for prayers for their families back home,” said Franco, translating the patients’ requests, “for security and for sincere confidence that God is with them here in this hospital.”
Hope is in short supply here.
So are vaccines.
“If our healthcare system had been frail before, it is worse now,” said Dr. Amanda Madrid, chief executive officer of Predisan, to a surgical team from the U.S. — the first to serve with the ministry in more than a year.
Honduras, like most of the world, is riding a wave of COVID-19’s highly infectious delta variant. At press time, the nation of 9.7 million people had reported nearly 345,000 infections and 9,050 deaths since the pandemic began. Many here believe the actual figures are higher. About 4 million doses of vaccine had been administered, according to Reuters’ COVID-19 Tracker, enough for about 20 percent of the population.
Lockdowns have shuttered businesses and schools. Mission teams have vanished, and nonprofits can’t employ the translators and drivers who serve them. Some, without income and fearing rising gang violence, have attempted the treacherous trek north through Mexico, contributing to a crisis on the U.S. border.
Making matters worse, Honduras endured two powerful hurricanes within two weeks in late 2020.
Health care was a challenge, even pre-pandemic, in rural locales such as Olancho, the largest of Honduras’ 18 departments, or states. Among its people are indigenous groups such as the Pech, who often lack resources to pay for adequate medical care.
That’s why Doris Clark, a member of the Northlake Church of Christ in Atlanta, and her husband, the late Dr. Robert Clark, moved to Catacamas — a town surrounded by Olancho’s rugged mountains — 35 years ago to launch Predisan, which takes its name from the Spanish words for “preach” and “heal.” Along with Madrid, Predisan’s founding medical director, they planted ministries for addiction recovery, medical care and community development.
In 2003, Predisan opened the Good Samaritan Medical Center, a 20,000-square-foot facility that offers primary and specialty care and training for medical workers. For nearly two decades, visiting teams of U.S. physicians have worked alongside Predisan’s Honduran staff to provide surgical and dental services.
In the midst of the pandemic, the ministry has adapted its services. With most schools meeting only online, Predisan set up tents behind the small chapel at the Good Samaritan facility and created outdoor classrooms and a tutoring program for students who don’t have reliable internet access.
Related: Covering COVID: Inside an ICU
Related: Covering COVID: Inside an ICU
Predisan established a pastoral network of preachers who serve in the mountain villages. The group offers financial training and pools its resources to provide microloans for ministers to plant coffee and supplement their income.
“Predisan, through the Gospel, has brought dignity to a people, has brought hope to a people,” said Julio Benitez, a ministry chaplain and psychologist. “And all of this has given new lenses to the people of this community.”
“Predisan, through the Gospel, has brought dignity to a people, has brought hope to a people.”
Before the surgical team began its work, Benitez preached to socially distanced, masked Hondurans waiting for their procedures. He quoted Jeremiah 29:11: “‘For I know the plans I have for you,’ declares the Lord, ‘plans to prosper you and not to harm you, plans to give you hope and a future.’” The verse follows 28 chapters of misery, suffering and hopelessness that the children of Israel endured at the hands of their enemies.
“As you can see,” Benitez said, “in the history of the children of God, it has always been that way.”
Nowhere is that sense of hopelessness more acutely felt than the San Francisco hospital in Juticalpa, about an hour west of Catacamas. It’s the only facility in Olancho with a COVID-19 ward, serving a region of more than half-a-million souls.
During the Chronicle’s visit, several patients convalesced in hallways between rooms. When asked about the ward’s capacity, coordinator Dr. Vilma Bendeck said, “We are living this right now. The limit here is 50. We have 56. We cannot say no.”
Dr. Franco, Predisan’s medical director, said that many Hondurans “feel that if they have COVID, that’s the end; they don’t have tomorrow.”
Their families suffer, too. Franco’s mother, Paulina, the namesake of his daughter, was hospitalized with the virus for 15 days in the city of Santa Rosa de Copán.
“I think that was one of my hardest moments,” the physician said. “I couldn’t stay with her in the room.”
Thankfully, a fellow doctor helped him set up a visit with her via mobile devices using WhatsApp. He tried to convince her that the hospital was the best place for her to be.
In the Juticalpa ward, Franco talked with 56-year-old Rosa Ramirez as she recuperated in the unit’s recovery area, a room once used for pediatrics. She said she was thankful for the visit and that she’s praying for all Hondurans to keep taking precautions against COVID-19.
“It’s a real illness,” she said, “not just a game.” Before leaving her bedside, Franco spoke a few words to her, softly, in Spanish.
“I was encouraging her to be patient,” the doctor said. “She wants to go home.”
In homes across Olancho, a new pandemic challenge may be on the horizon — a baby boom.
Two hours from Juticalpa, in the mountain town of Culmi, workers at a rural clinic overseen by Predisan are performing 16 to 18 ultrasounds per day, said Dr. Cruz Barahona. Access to contraception has been limited during the pandemic, he said.
The clinic is a part of a network of facilities overseen by Predisan since 2014, when Honduran health authorities launched a decentralization initiative and offered the ministry the chance to step in. The government provides some funds, with support from the Bill & Melinda Gates Foundation. Predisan trains staff and uses its own funds to provide chaplains for the rural clinics and maternity centers, where expectant mothers from remote villages can wait, under a physician’s supervision, for their babies to be born.
In recent months, as COVID-19 vaccines have become more widely available, workers in the clinics have prioritized getting pregnant women immunized. Hesitancy is a problem, said Dr. Oscar Guifarro, a coordinator for Health Center Emmanuel, a clinic in Catacamas that Predisan began supervising in 2016.
“Unfortunately, a pregnant woman died a month ago from COVID-19,” Guifarro said. As news spread, demand for the vaccine among pregnant women increased.
At a maternity center in Catacamas, the Chronicle spoke to two pregnant women. One, waiting for her first dose of the Pfizer vaccine, said she was doing it for her unborn child and her three children at home. Another woman said she didn’t yet want to receive the vaccine “porque no,” a Spanish phrase similar to “just because.”
In addition to administering vaccines, workers with Predisan helped set up the San Francisco hospital’s COVID-19 ward and managed it for a year. The ministry continues to provide chaplains for the unit.
Madrid, Predisan’s CEO, has visited several times. She remembered an early visit when a female patient, struggling to breathe, grabbed her arm.
“Do you want me to pray for you?” Madrid asked. The woman nodded.
“She couldn’t even get the words out,” said Madrid, who clasped her hand and prayed. She read to her from the Bible, one of the Psalms, and noticed other patients listening — plus some of the staff.
Inside the ward, one of the attending physicians, Dr. Noel Olivera, said the chaplains’ visits help remind him why he straps on layers of hot protective gear for shifts of 12 hours at a time.
“It’s stressful and uncomfortable,” Olivera said, “but I’m doing this for love.” Thanks in part to the spiritual inspiration, “most of these people will return to their families,” he said, motioning toward the recovery room.
Dennis Rojas, a lab tech, agreed. He cleans and comforts the patients, and the chaplains help remind him that he’s “proud to be a soldier in the war against the pandemic,” he said.
Madrid thought she would have to beg — or cast lots — to get chaplains for the COVID-19 ward. That hasn’t been the case. They’re eager, she said. They ask continually, “When is it my time to go?”
Rivera, at the end of his latest rotation as chaplain, stood outside the ward as a hospital worker sprayed him with a mist of water and bleach. Then he stripped off his gloves and gowns and placed them in a barrel. It’s a procedure he’s done before — and plans to keep doing as long as he’s needed.
“I feel most fortunate for the opportunity to pray and preach the Gospel,” he said. “I feel really proud to have the opportunity to come and be with these patients.”
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