Clinica Esperanza – Honduras
The clinic is located on Roatan, 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. Roatan’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 Roatan 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.
Location & Community
The largest and most populous of the Bay Islands, Roatan 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. Roatan boasts immense cultural diversity, with inhabitants of Hispanic, European, Garifuna, Caribbean, and Indian descent. Despite its pristine beaches, beautiful weather, and economic growth, Roatan still lacks modern infrastructure. Many residents subsist in sustained poverty and face daily hardships resulting from insufficient running water and electricity.
Become familiar with Honduran culture, history and economy by reviewing the Wikipedia Honduras Profile. Rich resources for Honduras health information include the Institute for Health Metrics and Evaluation IHME Honduras Country Profile and the World Health Organization Global Health Observatory Honduras Data.
Roatan 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 one’s home nationality. United States citizens can obtain current visa information from the website of the Honduran Embassy in Washington, DC. Residents of the United States, Canada or the European Union can normally receive a visa on arrival at the airport in Roatan. 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 Roatan.
Traveler’s Health & Safety
One should consult with their personal physician before traveling, and refer to the CDC Travel Website for the most up-to-date health information. 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 Roatan is chloroquine-sensitive, and P. falciparum is rarely encountered on the island. Chloroquine is the mainstay of prophylaxis in Roatan. 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 Roatan.
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.
Medical Care Services
Roatan’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 Roatan 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.
Public Health Initiatives
Most of the health challenges experienced on the island of Roatan are due to preventable or rather easily treatable diseases, including air-borne, water-borne, and insect vector-borne pathogens. Malnutrition, both under-nutrition and over-nutrition, is a very prominent risk factor the chronic conditions of diabetes, hypertension, respiratory distress, and musculoskeletal complaints. Injuries related to burns, fall, and motor vehicle trauma remain frightfully common.
In response to these health challenges Clinica Esperanza places strong emphasis on health education and patient teaching. The pace of the clinic usually provides ample opportunity for one-on-one patient counseling. Group educational sessions are also provided for the more common concerns such as over-nutrition and diabetes management. Prenatal care and well-child care are also offered. Students are invited to participate in all aspects of public health at Clinica Esperanza.
Healthcare Profession Staff
Day to day leadership of Clinica Esperanza is provided by Peggy Stranges, RN, originally from Ohio and living in Roatan 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. Previous INMED Learners who served at this training site include these Graduates.
Student Lodging & Meals
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 cafes on the island. Telephone service is also accessible.
Clínica Esperanza operates entirely on donations of equipment, money, and personnel. All volunteers, including INMED students, are expected to participate in this essential aspect of Clínica Esperanza.
Clinic duties usually end by 3 PM, after which there are many options for fun. Diving is beautiful in Roatan 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. Roatan also offers abundant opportunities for swimming, snorkeling, and enjoying the beaches.
Behavior & Dress
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.
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. 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.