Summary

The clinic is located on Roatán, one of the Bay Islands, just north of the Honduras mainland. Despite its remarkable beaches and beautiful weather, many residents live in sustained poverty and suffer from common chronic diseases, as well as from malaria, dengue, intestinal parasites, malnutrition and sexually transmitted illnesses. Roatán's preexisting medical care system consists only of overburdened government facilities that lack the most basic resources.

Clinica Esperanza's vision is to provide the finest medical care possible to all Roatán residents, regardless of income status. The clinic was launched in 2001 and now performs over 1,000 consultations a month. The clinic is also progressively adding additional services, including laboratory, ultrasound and minor procedures. Medical education is a high priority at Clinica Esperanza, with supervision provided by both American and Honduran physicians and nurses.

The largest and most populous of the Bay Islands, Roatán is located 35 miles off the northern coast of the Honduras mainland. The island is 30 miles long and 2 miles wide, with a population of some 80,000 people. Roatán boasts immense cultural diversity, with inhabitants of Hispanic, European, Garifuna, Caribbean, and Indian descent. Despite its pristine beaches, beautiful weather, and economic growth, Roatán still lacks modern infrastructure. Many residents subsist in sustained poverty and face daily hardships resulting from insufficient running water and electricity.

Roatán International Airport is served by several airlines. The Clinic can arrange for pickup from the airport, and taxi service is readily available.

For current information, please visit the Honduran Embassy website appropriate for your country. United States residents can visit the Honduran Embassy in Washington DC at http://www.hondurasemb.org. Residents of the United States, Canada or the European Union can normally receive a visa on arrival at the airport in Roatán. On the entry declaration form, please check "Other" for "Reason for Travel" and write in "Volunteer." Those staying greater than 30 days will also need to present a Volunteer Immigration Letter to immigration upon arrival. Visitors must be prepared to pay an airport tax in cash when departing Roatán.

Please check the CDC travel website for the most up-to-date health information: http://wwwn.cdc.gov/travel/default.aspx and consult with your physician before traveling. Visitors are encouraged to drink plenty of water, to apply sunscreen in the daytime and apply insect repellant (at least 20 percent DEET) in the evenings. Malaria prophylaxis is recommended. Fortunately, malaria in Roatán is chloroquine-sensitive, and P. falciparum is rarely encountered on the island. Chloroquine is the mainstay of prophylaxis in Roatán. Vaccination against Hepatitis A, Hepatitis B and typhoid should especially be current. Visitors should bring adequate supplies of personal medications, as these may be unavailable in Roatán.

Travelers are advised to regularly check the U.S. State Department website for the most up-to-date information regarding country specific travel information and travel advisories: http://www.state.gov/travel.

60 percent of patients coming to Clinica Esperanza are children, 30 percent are adult females, and another 10 percent are adult males. The most common illnesses among children include upper respiratory infection, asthma, intestinal parasites (ascaris, hookworm, giardia), bacterial skin infections, scabies, diarrhea/dehydration, malaria, and dengue. The most common illnesses among adults include hypertension, diabetes mellitus, urinary tract infection, upper respiratory infection, intestinal parasites, bacterial skin infections, musculoskeletal complaints, and pregnancy concerns. In addition, people are also encountered at Clinica Esperanza who suffer from malnutrition, HIV, tuberculosis, burns, abscesses, lacerations, lower respiratory infections, and sexually transmitted illnesses,

About 70 percent of patients speak Spanish and 30 percent speak English. For maximum effectiveness, volunteers should be able to function independently in Spanish.

Roatán's medical care system consists of overburdened government facilities, which are available to the poor but lack in the most basic resources, and privately owned facilities that are entirely unaffordable. In this context, Clinica Esperanza brings a vision to provide the finest medical care possible to all Roatán residents, regardless of income status. The clinic was launched in 2001 by the Bay Islands Community Health Association; a nonprofit, tax-exempt, non-denominational Christian organization certified both in Honduras and in the United States.

The clinic currently performs over 1,000 consultations a month. In addition to outpatient consultations, the clinic also provides a number of procedures such as suturing and ultrasound. Basic laboratory is available on site. Since patients are of humble means and are paying for their care out of pocket, new clinicians frequently discover they must limit their reliance on technology and hone their history and physical examination skills.

http://clinicaesperanza.com

Day to day leadership of Clinica Esperanza is provided by Peggy Stranges, RN, originally from Ohio and living in Roatán since 2001. Patrick Connell, MD, a board-certified emergency medicine physician from Arizona, is on site approximately six months per year, serving as the clinic's administrative volunteer and medical advisor. Dr. Raymond Cherington is a bilingual, fully credentialed Honduran trained general doctor who serves as the clinic's medical director and attending physician. He is assisted by Dr. Ivan Pineda, a residency trained Honduran pediatrician, and by Dr. Delmy Duarte, a Honduran dentist.

Clinica Esperanza is committed to assisting healthcare professional students who wish to experience and learn the nuances of providing healthcare to the people of the Bay Islands. Student roles will be in proportion to their skill and scope of training, all the time ensuring that patients receive the best care available. Student responsibilities may include taking histories, vital signs, wound care, pharmacy and working alongside the physician. The emphasis is on learning about local health patterns, health behaviors, and disease management.

Several low-cost lodging options are available in the area, including hotels and apartments. Some of these also provide meals. Grocery stores and restaurants are plentiful.

Wireless Internet is available at the clinic and at Internet cafés on the island. Telephone service is also accessible.

Clinic duties usually end by 3 PM, after which there are many options for fun. Diving is beautiful in Roatán and said to be the least expensive anywhere in the world. There are several dive shops that cater to clinic volunteers and offer a nice discount to those wishing to become certified divers. Roatán also offers abundant opportunities for swimming, snorkeling, and enjoying the beaches.

Clínica Esperanza operates entirely on donations of equipment, money, and personnel. INMED invites all participants to consider raising extra funds to donate to support the facility. This is not required but allows INMED participants to become involved in every aspect of medical missions.

Volunteers are counseled to be careful concerning their behavior on the island after working hours. As representatives of the Clinic, their actions are immediately noted by local residents and influence the reputation of the clinic. At the clinic, volunteers usually wear scrubs, shorts and sandals. The culture is conservative, so dress should be appropriate.

Volunteers should bring copies of any health profession license, diploma, or certification. Also, volunteers need to bring a stethoscope, medical handbooks, laptop computer, USB drive, and flashlight. If one intends to do any snorkeling, bring snorkel mask and fins, for rentals are expensive.

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