Clinica Evangelica Morava – Honduras
This medical ministry serves the indigenous Miskito people of eastern Honduras via an active outpatient service and a public health program that focuses on prenatal care, midwife education, nutrition, vaccination, and HIV detection and prevention. The hospital averages about 10-20 inpatients, and provides obstetrics care and general surgery. The goal is excellent, compassionate care in the context of spiritual support and limited resources.
Students must be able to function independently in Spanish, and will participate in the full array of clinical services. Clinica Morava’s three full-time physicians complement each other with their skills and experience, and offer learners insights into the relationships between health in its social and cultural context. More than one hundred medical students and residents have worked at Clinica Morava since it was opened in about 1950.
Location & Community
The town of Ahuas is located in eastern Honduras, about 30 miles from the Atlantic coast, and up the Patuca River from the town of Brus Laguna. This region of Honduras is known as La Mosquitia. The landscape is tropical, with thick forests, few roads on the savannah, and many rivers. Miskito villages are scattered mostly along rivers, several large lagoons, and the Caribbean Coast. The rainy season lasts from June trailing off into December. The dry season is from January to May. Most of the year the temperature varies between the mid 70’s and 80’s F, and rarely below 65 degrees or above 95 degrees. A brisk ocean breeze usually moderates this tropical climate.
Visitors usually fly into the city of La Ceiba, Honduras. Flights are easier to schedule into San Pedro Sula, however, and many chose to take the four-hour taxi into La Ceiba from the San Pedro airport, providing some views of the former Banana Republic’s scenic countryside. Very reasonable taxi service is available in the cities (but be sure you agree on a price before you get in the taxi). A reservation will be made in advance at the Gran Hotel Paris in downtown La Ceiba. No commercial flights are currently offered into Ahuas. Most travelers prefer to have Alas de Socorro (based in Ahuas) fly one of their Cessna 206’s into La Ceiba to pick them up. For more adventure, one can fly commercial on a twin turboprop with SOSA or AeroCaribe to Puerto Lempira, then board a fast outboard to cross the lagoons. We can help arrange either route. Once arriving in Ahuas a representative will meet arriving visitors. The return trip to either La Ceiba or San Pedro Sula is usually the reverse of the incoming flight.
For current information please visit the Honduran embassy website appropriate for one’s home nationality. United States citizens can obtain current visa information from the website of the Honduran Embassy in Washington, DC. Americans are normally granted a visa upon arrival in Honduras to stay for up to 30 days. An advance visa application is not necessary, and a 30-day visa can be extended up to three months. At immigration at the airport a yellow slip of paper, the visa itself, will be stapled into passports and but be returned upon departure. When departing Honduras travelers must pay an airport tax in US Dollars.
Traveler’s Health & Safety
Malaria is endemic in La Mosquitia, but can effectively be avoided taking appropriate prophylactic medications and personal precautions. One should consult with their personal physician before traveling, and refer to the CDC Travel Website for the most up-to-date health information. Travelers are advised to refer to the United States State Department Website for the most up-to-date nation-specific travel information, and to regularly review Current Travel Advisories.
Most people of this region are Miskito, rather than Hispanic. Miskito are indigenous inhabitants of Honduras who have a distinct language, though many also speak Spanish. Most make a living as subsistence farmers. They generally travel by foot or by small boat on nearby rivers. Malaria, tuberculosis, intestinal parasites, and malnutrition are common health problems. Increasingly as some take on more sedentary employment as teachers, merchants, and pastors, obesity is becoming a scourge with a secondary diagnosis of diabetes.
The native language of this region is Miskito, though many people also speak Spanish. Students and residents must be able to function independently in Spanish. Clinic staff is available to translate for Miskito-only speaking patients.
Medical Care Services
The Clinica Evangelica Morava has an active outpatient service that provides primary health care for both the local population and for those who travel to the Clinica via the River Patuca and by small aircraft. Malaria, diarrhea, pneumonia, malnutrition, skin disorders, trauma and birth complication are frequently managed. Inpatient hospital care in provided for 10-20 patients at any one time. Orthopedics, obstetrical care, and general surgery services are available with limited support from laboratory, ultrasound, and radiology. Clinica Evangelica Morava sees 5,000 outpatients and 700 inpatients each year, and attends 160-180 deliveries annually.
Public Health Initiatives
Women of La Mosquitia typically deliver their children at home. Or, like the intermittent rains of eastern Honduras, they pour into the Clinica Evangelica Morava with delivery complications. These stem most frequently from underlying anemia, malnutrition, and misunderstanding about pregnancy, including delayed care. Among the Clinica’s public health initiatives, midwife classes, intestinal parasite control, nutrition education, and prenatal care are very high priorities. The local government Health Centers are increasingly taking an active part in this. Transportation is very challenging in this region of jungle, savannah, and swamp. Therefore another high priority public health initiative is training village health workers. In the context of eastern Honduras these individuals provide mosquito vector and malaria awareness, management of common illnesses, and innovations for safe drinking water. They also play an important role in immunization and education of essential healthcare issues.
Healthcare Profession Staff
Clinica Morava’s lead physician is Dr. Ovelio Lopez, Director of the Moravian Medical Program in Honduras, and Dr. Benno Marx, Hospital Director. Dr. Lopez completed his medical degree from Havana, Cuba, in 2008, did further studies in Venezuela, and then obtained his full licensure with the Medical College of Honduras. He worked one year at the Moravian Clinic in Cauquira, Honduras, before assuming his present position at Ahuas in 2012. Dr. Lopez is also assisted by Dr. Benno Marx, who graduated from the Guatemala National University Medical School in 1983, finished a Family Medicine residency at East Carolina University in North Carolina in 1987, then did a special surgical fellowship at Bowman Gray School of Medicine of one year. The Marx family worked at the Ahuas Clinic for 7 years, then moved to Washington State, where Dr. Marx worked at the Farm Workers Clinic for 18 years, before returning to Ahuas in 2012.
More than one hundred medical students and residents have worked at Clinica Morava since it was opened in about 1950. Clinical responsibilities normally include daily outpatient clinic and inpatient rounds, as well as assisting in obstetrics and general surgery. The medical staff will meet with students individually to discuss patient care and public health issues.
Student Lodging & Meals
Room, meals and laundry are provided at a nominal cost to visitors. The food is simple but good. Rice with coconut, and beans, is delicious! Accommodations in Ahuas are simple, similar to summer camp, with running water and showers. The clinic enjoys continues electricity from a large solar panel/battery bank system, although power is limited during night hours; a diesel generator provides backup.
Communication to Ahuas or Honduras has improved vastly in recent years over. There are five cell phone towers in Ahuas, including 3G capability, and many people own their own cell phones (using CLARO or TIGO). Calls or messaging to the U.S. is very reasonable. While one can bring their own cell phone from the North American, they must be unlocked first. It is often easier simply to buy a local phone with prepaid cards as needed.
INMED invites all participants to consider raising extra funds to financially support this facility. While such efforts are not required, they provide opportunity for INMED personnel to become involved in this important aspect of international healthcare.
Movies, shopping and restaurants are available in La Ceiba, but Ahuas is an isolated town without these amenities. Good conversation, board games, music, hunting and crafts comprise wholesome evening entertainment.
Behavior & Dress
Lightweight cotton clothing is best for the hot and humid weather. Clothes dry slowly; so lightweight material is best. Dress is conservative. Scrubs are often worn during work. Men should wear pants in the clinic/hospital. If doing outdoor physical labor, shorts are acceptable, but not above the knee, unless for sports. Pants are preferable. Shirts should cover the shoulder. For Sunday church, men should wear pants.
Women should wear cotton skirts or pants in the clinic/hospital and pants for physical labor outdoors. Women are discouraged from wearing shorts. Modest sleeveless blouses are fine. No Spaghetti straps, tank tops. Scrubs also fine. For Sunday church, women need to wear a skirt. Pants or shorts should not be worn to church. A physician’s jacket is optional and not necessary.
For both men and women: Pierced body parts should be always covered.
What To Pack
Visitors should bring copies of all healthcare profession licenses, diplomas, or certifications. A carry-on bag should be packed that contains essentials items just in case one’s luggage becomes lost. Bring clothes appropriate for the weather.
Above all, please bring: A Great Attitude!
Documentation: passport, small English/Spanish dictionary
Cash: for sodas, snacks, postcards
Clothing: sun hat, sunglasses, swimsuit and towel, hooded poncho and/or umbrella for rain and boat travel, comfortable work shoes, sandals and flip flops for the shower.
Hygiene: all toiletry products that will be needed, wash cloth and towel, sunscreen/sun block, bug repellant for clothing and skin
Electronics: camera/batteries, laptop, and ipad (3G available but may require a visit to the TIGO office in La Ceiba first to configure), flashlight/batteries
Do not bring: cigarettes or alcohol, tight clothing, or short shorts.