Kathleen and I went on a medical mission with the International Health Service of Minnesota (https://ihsmn.org/about/), which has been providing medical and dental care to remote areas of Honduras since the 1970s. Kathleen heard of IHS through a friend, who knew that she had done a previous medical trip in Peru and enjoyed the experience. For this mission, approximately 50 IHS volunteers were divided into five teams, with Kathleen assigned as the Pharmacist for Team Lisangnipura and I went along as one of several general helpers in our 11-person group.
Honduras is the second-largest country in Central America, after Nicaragua. Named in 1502 by Christopher Columbus on his fourth and final voyage, Honduras means “depths” in Spanish, a reference to the deep coastal waters that Columbus found in the Bay of Trujillo on the Caribbean Sea. The Maya ruled here until the ninth century, eventually yielding to other indigenous peoples, most notably the Lenca. After 1502, a series of Spanish conquistadors invaded, meeting fierce resistance from the Lenca chief and Honduran national hero Lempira and his coalition of natives. Spanish weapons and European diseases defeated the native armies, Lempira was assassinated in 1536 at a peace treaty negotiation and the resistance to Spanish colonization was largely over by 1540. Independence from Spain would not come until 1821, and instability ensued, with power alternating between civilian governments and military regimes, accompanied by hundreds of coups and rebellions over the next 150 years.
The country was the original “Banana Republic”—the name was coined by author O. Henry in the early 1900s, when the Honduran economy, infrastructure and government were dominated by foreign business interests, primarily American-owned fruit plantations. Inspired by his personal experience in Honduras during this period (after fleeing embezzlement charges in the U.S.), Henry described how the country’s fortunes came to depend almost entirely on banana exports in his 1904 novel Cabbages and Kings.
On October 29, 1998, Hurricane Mitch, the deadliest Caribbean storm in 200 years and the second-deadliest on record, made a direct hit on the Honduran coast. Nearly 11,000 perished, 1.5 million (about 20% of the population) were left homeless, and the damage to agriculture and infrastructure set the country’s economic development back an estimated 50 years. Following this devastation, the name “Mitch” was retired and will never again be used to name a tropical cyclone.
Honduras today faces significant challenges, including high crime, corruption and inequality, with a newly inaugurated president, Nasry Asfura, pivoting away from China and towards the United States. A whopping 60% of the population lives in poverty, and climate issues have exacerbated economic instability and the potential for a humanitarian crisis. The U.S. State Department lists Honduras as a Level 3 destination, which advises visitors to “Reconsider Travel.” We went anyway, and here’s what we found.
Wednesday, Feb 18: Kathleen and I flew from Atlanta (see previous post) to San Pedro Sula, Honduras’ second-largest city (after the capital, Tegucigalpa), and the country’s main industrial and economic hub. After clearing immigration and customs, we met our IHS-arranged driver, and Rick, another volunteer, who had landed earlier. It was a 3.5-hour drive on a bumpy, mostly two-lane road to La Ceiba, a major port city on the Caribbean. The long journey was a great introduction to the interior of Honduras, with views of lush green mountains, national parks and forests, pineapple fields, coconut groves, roadside vendors and shops, pedestrians, bicycles, motorcycles and at least a half-dozen police checkpoints.
Founded in the 1870s around a large ceiba tree, which gave the town its name, La Ceiba became an important shipping port for the banana and pineapple industries, and pineapple remains the city’s main export. The population of 200,000 swells by an additional 500,000 during its annual Carnival held each May. Map link: La Ceiba, Honduras. We checked into the Gran Hotel Paris, the in-country IHS headquarters, settled into our room, then met five other IHS volunteers at the pool bar for a drink, followed by dinner at the hotel restaurant, delighted to learn that we had a daily meal allowance, provided by IHS.
Thursday, Feb 19: We met our group for breakfast at the hotel’s poolside courtyard, had a short planning session, then went around the corner to the nearest bank to exchange currency. We were advised to only use ATMs during daylight hours and at banks with armed guards, due to targeting by criminals. The Banco de Occidente had multiple guards inside an out, armed with shotguns and automatic rifles, a metal detector and a DMV-style waiting area with about 50 customers inside. In 1931, Honduras renamed its currency after Lempira, the 16th-century Lenca chief who led the resistance against the Spanish. One Lempira is worth about four cents, or an exchange rate of 25-ish Lempira to the U.S. dollar.
We took a walking tour of La Ceiba, through the downtown commercial district and out to the attractive coast. We picked up a few supplies for the mission, then hung around the hotel’s courtyard and balcony, enjoying the trade winds coming off of the Caribbean and checking the results of the Winter Olympics online. We couldn’t find any television coverage of the games and the locals we asked seemed understandably indifferent to winter sports.
Friday, Feb. 20: We woke up at 6:30 AM, had breakfast, checked out of the hotel and took a bus to the airport for the 1.5 hour flight to Puerto Lempira with six other team members, four from Minnesota. At the airport, we learned that our group’s luggage was 70 pounds over the limit for our 19-passenger, Twin Otter aircraft, and three of our group had to leave personal bags behind that would be sent along on the next flight, three days later. Many of us were carrying supplies for the mission clinic in our luggage, items which could not wait until Monday. The views of eastern Honduras from the plane were stunning, with coastal, mountain, farmland and wetland environments all visible, sometimes simultaneously. One-fifth of the country is protected as national park or preserve, although the government lacks the resources and political will to adequately stop development and deforestation on public lands—an estimated 2% of it’s dense forests are cut down annually.
Puerto Lempira is the capital of the Gracias a Dios department (like our states) and is located on the Caratasca Lagoon in the northeast corner of Honduras. Map link: Puerto Lempira. Gracias a Dios (“Thanks to God”), also named by Christopher Columbus, has a Level 4 designation (the worst possible) from the U.S. State Department: “Do Not Travel,” due to violent crime and gang activity and U.S. government employees and their families are forbidden to go there. That hasn’t always been the case—in the 1980s, the region was a key staging area for CIA and military personnel aiding the Nicaraguan Contra rebels fighting against the Sandinista government. Accessible from greater Honduras by air or water only, the town has one paved road, a gravel-runway airport, large pier, hospital, three supermarkets, one bank and an ATM. The population of 25,000 is more than 80% Miskito, the indigenous people native to the Caribbean coastal and lowland areas of Honduras and Nicaragua.
We landed on the gravel airstrip, which runs through the center of town, unloaded our gear and walked the several blocks to the San Jose Catholic Church compound where IHS administrators have stored supplies and directed missions from for many years. We would spend two nights here getting oriented and assembled, and waiting for the rest of our team to arrive from La Ceiba. We had lunch in town at Coffee Roll, then spent the afternoon sorting through drugs, medical supplies, food and support equipment for our remote clinic. The power went out for about 30 minutes, which is apparently a regular occurrence here. In the evening, I began my work as a general helper, mopping the floor after a faulty five-gallon water bottle leaked all over the men’s dormitory, then read until bedtime in my rustic bunk bed, complete with mosquito netting.
Saturday, Feb. 21: Barking dogs woke me up at 2:00 AM, then I was up for the day at 6:00 AM. We walked to breakfast at the Yu Baiwan (“sunrise” in Miskito) Hotel, where the morning menu had one item; “desayuno tipico” (“typical breakfast”), which we all ordered with coffee and water. Consisting of scrambled eggs, refried beans, cheese, tortillas and butter, it was filling and tasty. Back at the church compound, we finish provisioning and packing up supplies as the temperature climbed to 87F, complete with tropical humidity. After our work was done, most of us lounged in the shade, reading, staying connected via our Starlink satellite internet, and watching the butterflies, hummingbirds and sheep in the church courtyard. Dinner was at Coco Bar and Restaurante—their chicken tacos was the best meal that I’d had so far in Honduras, and we received a surprise gift from the restaurant owner of two pints of gifiti, a traditional herbal-infused rum beverage from the indigenous Garifuna culture of the Honduran Bay Islands.
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| L to R: Tony, Lynn, Veronica, Dale, Seth, Bonnie and Kathleen |
Sunday, Feb 22: After breakfast, we packed up our personal and clinic gear, loaded up on three trucks and went to the airport to pick up our last four team members. After they landed, our 14-person Team Lisangnipura was now complete; consisting of a team leader, assistant leader, two doctors, a dentist, a pharmacist, three nurses, an EMT, three helpers and a local Miskito liaison. Our dentist and two of the nurses were also Hondurans; Veronica the dentist from Tegucigalpa, Sharon from Puerto Lempira and Morfy from Lisangnipura. We piled into the three vehicles, most of us riding on wooden benches in the truck beds, and drove south on the bumpy dirt road into La Moskitia, the second-largest rainforest in the Americas after the Amazon, and one of the last wilderness areas in Central America. We crossed 11 rickety-looking bridges, where passengers disembarked and walked across as the drivers and their helpers positioned boards to match the wheelbase of each vehicle as it gingerly crossed. Government funds to maintain these bridges are scarce and the locals said that high waters and swift currents during the rainy season make it difficult to stay ahead of nature and keep these bridges operating, but the road is a key lifeline to these communities and they persevere. Along the road, we marvel at the beauty, expanse and variety of the scenery; forest, pine savannah, rolling hills, rivers, creeks, and wetlands with the occasional wooden house on stilts. Shortly out of Puerto Lempira, we passed a home with a police car in front and people carrying a coffin inside, and later learned about the tragic death of a teenaged boy who was electrocuted while climbing a mango tree too close to a power line.
After three hours of hot, dusty, bumpy travel, we reached the village of Lisangnipura, where it seemed that the entire population turned out to see us. We quickly set up our clinic, dormitory and kitchen/dining hall and finished by headlamp after the sun set, as there was no electricity. Our sleeping quarters were inside the local church, where we pitched tents for privacy and insect protection on the concrete floor. Sturdy wooden pews doubled as seating and shelving and we set up a changing room and nighttime privy on one side of the altar. Dinner was crackers, peanut butter sandwiches and other handhelds, washed down with water and powdered drink mix. We were all hot, sweaty and tired when it was time to turn in, looking for a good night’s sleep before our first day of clinic in the morning.
Sleep was nearly impossible, however. Unbeknownst to us, the young man who perished had roots in Lisagnipura, and the Miskito tradition is to hold an all-night, community-wide wake to send off the soul of the departed. There was music, singing, chanting, vehicles driving around and the unmistakable roar of a chainsaw, which we later learned is used to keep celebrants from falling asleep (it’s very effective). Hour after hour, we lay awake listening to the din, having no clue what was happening and letting our imaginations run wild. Was this being done to intimidate the gringos? Did they not want us here? Are they coming for us? Perhaps Gracias a Dios really does deserve a “Do Not Travel” designation?
Monday, Feb 23: The celebration continued until sunrise, and despite the constant noise, many of us were so tired that we nodded off for a couple of hours. After a breakfast of oatmeal, we finished setting up the clinic, with a planned opening of 10:00 AM, although people started lining up as early as 8:00 AM. Few patients spoke Spanish—only Miskito—so Morfy and Sharon paired with Dr. Beth and Dr. Mike, acting as nurse/translators. Kathleen had a local pharmacy tech, Cipriano, who had worked with IHS clinics before, and he helped fill prescriptions and translated at the pharmacy window. Sometimes questions and answers went from English to Spanish to Miskito and back again, but the staff handled it well and kept things moving.
It was hot and humid, but a nice breeze coming through the open-air clinic kept things comfortable. I partnered with Seth, the husband of Bonnie, our American nurse, and we got to work. Some of our job was defined, like helping with meals, washing dishes, maintaining physical security of our property, and running the generator and monitoring power to keep our Starlink internet system operating. The rest was less clear, and we initially focused on making our church dormitory as livable as possible, doing whatever was asked of us or otherwise staying out of the way.
A Toyota pickup truck provided daily (except Sundays) taxi service to the village. Today it brought out some extra supplies for the clinic, then doubled as an ambulance and hearse on its return to Puerto Lempira—a woman with suspected gall bladder disease was referred to the hospital by our doctors and the coffin carrying the deceased boy was taken to the cemetery.
After we finished our first day in the clinic, I waited for Kathleen to fill the last of the prescriptions—the pharmacist is usually the last one out—then we took a quick bath in the Lisangni River. I helped make a dinner of freeze-dried pork chops, fried onions and boiled potatoes and carrots, eaten by candlelight and electric lantern in our combination headquarters/kitchen/dining hall/team leader bunk room, which until yesterday was a vacant house. Water for the clinic and kitchen came in five-gallon buckets carried by hand or wheelbarrow from a cistern or the river by Amanis, a local man. He also kept us supplied with flushing water for the clinic toilets, which operated by pouring water into the bowl until they flushed by gravity. We brought some bottled water for drinking, but when it ran out we filtered the local water and added a little bleach for purification.
Missions in Honduras are typically scheduled during the drier months of the year (February-April), except for one site, which requires higher water levels to get a boat upriver with volunteers and supplies. Even during the dry season, several inches of rain per month are normal and we experienced heavy downpours and high winds overnight, which exposed tonight’s source of noise; a loose corrugated roof panel that banged in the breeze.
Tuesday, Feb 24: The rain and winds brought cooler temperatures and more comfortable humidity levels, although the ground was soggy and filled with puddles. There are no sidewalks, and the soccer field that we crossed several times daily was also a cow and horse pasture, so care had to be taken where you stepped.
Lisangnipura did not exist before Hurricane Mitch hit in 1998. Villagers from other areas whose homes were destroyed relocated to this slightly higher ground along the Lisangni River and the new pueblo was born. All homes that we saw were elevated, as high water during the rainy season—which is most of the year—necessitates living well above ground. The clinic is on a concrete slab, and was built by Swiss aid workers and electrified with solar panels up until earlier this month, when a break-in occurred and key components of the system were stolen. Following this theft, IHS paid to have steel bars installed over the windows and doors, which were completed just prior to our arrival. The walls are open cinder blocks, built for maximum ventilation and airflow, which is nice, except when someone is burning trash or a field and the wind carries the smoke into the clinic.
Yesterday, we treated about 50 medical and 25 dental patients, although twice that many came seeking treatment. We learned that people from surrounding villages are walking as much as four hours to get here, and a system was initiated to prioritize these travelers to be seen in the morning so they might return home before dark. I marveled at the patience and compassion of our doctors and nurses, who spent considerable time with each visitor. Many large families entered together, and it was common to see groups of seven or more sit down at once to be seen. For many in these remote villages, missions like these are their only regular professional medical care, and for some it was their first-ever visit to a doctor.
More bilingual (Spanish/Miskito) locals joined our clinic staff—Edna and Vida checked in patients, Linda worked in the dental room, Calero manned the eyeglasses table and Tio worked front door security, although his biggest problem was keeping out stray dogs. Maintaining order was not too difficult—clinic visitors waited patiently, children played quietly and minded their elders when they got too squirrelly. People did press in towards the entrance occasionally, but it was mostly to get out of the hot sun and to see what was going on inside. As is said in boating, “sometimes you watch the show, sometimes you are the show,” and this week we were the show. The locals followed our every move, and it took some getting used to. Every window in the clinic had faces looking in and every task we performed had an audience. Kathleen was always visible from the outside through the pharmacy window and people stared in, occasionally giggling when a wind gust scattered her papers. The Miskito were pleasant and friendly when addressed, but not overly outgoing, and many had that thousand-yard stare that I’ve seen before on people living in poverty. The clinic was the hub of local activity, and people didn’t leave immediately after being seen and treated. After picking up their prescriptions and vitamins, folks lingered, catching up with friends, neighbors and extended family, or just watched the show.
Seth and I ran low on general helper work after washing the lunch dishes, so he kept the clinic staff caffeinated with afternoon coffee service, while I started a project to pick a bicycle lock whose combination was lost. Helping cook dinner was on hold, as our plan for the remainder of the mission was to have a local woman prepare our evening meals. Beans, rice, tortillas or empanadas, slaw and fruit were usually ready by 6:30 PM, followed by a team meeting where the day’s events and ways to improve were discussed. We saw another 50-ish medical and 25 dental patients in the clinic today. Veronica, our Honduran dentist, maintained a constant cheery attitude, despite the fact that many of her patients ended up having teeth extracted rather than filled, crowned, bridged, etc. as they would in an urban environment where multiple visits would be the norm.
Wednesday, Feb 25: Crowing roosters woke me up around 6:00 AM as it started to get light, then I dressed and ate scrambled eggs for breakfast. We have no refrigeration, but eggs keep just fine, although transporting them from Puerto Lempira on the bumpy road was a challenge. Clinic patients began lining up before 8:00 AM, and there was a decent crowd when we opened.
One table in the clinic was set up to hand out eyeglasses to those who needed them. The glasses came from the Lion’s Club (https://www.lionsclubs.org/en), who have been recycling glasses since 1967. Sunglasses, reading glasses and prescription eyewear collected from Lion’s Club donation bins are sorted and provided to missions like IHS to distribute to those who don’t have access or cannot afford them. Our glasses was very popular, especially the sunglasses, as most Miskito people spend the majority of their lives outdoors.
In the afternoon, Seth optimized our charging system for personal devices, while I worked on repairing the loose panel on the church roof. After 4:00 PM, patient flow ebbed, and we were closed by 5:00 PM. Most everyone took a bath in the river, then ate rice, beans and tortillas by candlelight. At the evening meeting, there was more discussion about prioritizing traveling patients in the morning. Sharon told the story of one mother who came in yesterday but arrived too late to be seen. She and her children slept in an abandoned house in Lisangnipura, then came to the clinic with no food for the day. Another family walked 12 hours over three days to be here. It was clear that our young Miskito nurses, Sharon and Morfy, cared deeply about their people and were comfortable advocating for them. I was equally impressed that our IHS clinical and team leaders really listened, and to the best of my knowledge, implemented every one of the nurses’ suggestions.
The clinic became our post-dinner hangout. For one, there was a 12-volt electric light bulb that worked, powered by the solar panel on the roof and a battery. Second, it’s where the toilets were, although there was a tarantula in the women’s bathroom rafters, as well as a scorpion in the battery room, a large toad residing in the pharmacy and, like every building we occupied, home to several bats. Most importantly though, the clinic had the strongest internet signal and everyone enjoyed catching up and keeping up with their lives back home.
Back at the church, we found another scorpion and a couple of large spiders lurking near one of the tents—the spiders were dispatched with a large wooden crucifix (forgive us, Lord), but the scorpion was left alone. On the bright side, the roof repair was holding in the wind, so that noise was gone, and only barking dogs and snoring humans disturbed our sleep.
Thursday, Feb 26: Every night’s slumber was better than the previous one, and I slept uninterrupted until 5:00 AM. Breakfast was at 7:00 AM, then the clinic opened at 8:15 AM. We now had separate lines for locals and those who had traveled to be here, rather than waiting until the intake interview to sort patients. The rain, heat and humidity returned, and we put up a canopy and repositioned church pews outside the clinic to protect those waiting from the elements as best we could.
It was day 4 of 8 at the clinic. Seth and I fussed with the location of our Starlink router to optimize the signal in our HQ/kitchen/dining area, clinic and church dormitory. I found a phone app online that controlled our battery power supply remotely and completely geeked out playing with this new technology. The battery didn’t have enough juice to run all night long, and team members enjoyed using the Starlink wifi in the evening. With the new app, I was now able to turn everything off at bedtime from inside my tent, rather than walk back to the clinic in the dark across the cow-pie field.
Seth and I had little to do and tried to make ourselves useful without getting in the way. The high points of my day were chatting with Evan while doing the lunch dishes, hanging out with Seth and conversing with Hilario, our local liaison. I found his Spanish easy to understand and we had long discussions about his experiences with IHS and life in La Moskitia. After the last patient was seen and the pharmacy closed, the routine was familiar: bathe in the river, eat our beans and rice, linger in the clinic and go to bed in the church, with most of us heading inside our tents by 8:00 or 9:00 PM.
Friday, Feb 27: I awoke at 5:30 and could already feel that it would be a still and steamy day. Smoke from a nearby field made the sky hazy and the pueblo was quiet as I watched the cows and horses graze and dogs roam. Our team began stirring and villagers headed down to the river to fetch water for the day. After morning ablutions, I went to the clinic to turn on the Starlink, then Seth and I set up outside before folks arrived. Breakfast was oatmeal and granola, then Day 5 of the clinic began. This morning several dozen children from nearby schools arrived en masse, and they all received vitamins and deworming pills. Sadly, we later found empty vitamin bags on the ground, suggesting that many of the kids ate their whole allotment in one go.
A pregnant teenager complaining of abdominal pain was referred to the Puerto Lempira hospital yesterday, but didn’t return today for her taxi ride. Morfy offered to pick her up by motorcycle and drive her, but the bike had a flat tire, and there wasn’t a spare inner-tube in the village. A mother and daughter presented with difficulty walking and using their hands, which were deformed. Our doctors scratched their heads for a moment, then realized that they were seeing leprosy for the first time in their careers. The two women were also referred to the hospital and placed in the next taxi to Puerto Lempira.
When I typed “Lisangnipura, Honduras” into Google Maps, there were no results. We were quite literally not on the map, and as I stared off into the forest and across the fields and savannah, I wondered how many more places like this existed in Gracias a Dios, in Central America and on Earth. Map link (dropped pin): Lisangnipura, Honduras
The heat, humidity, barking dogs and crying babies started to get to me, and it was exacerbated when smoke from burning trash blew through the clinic. Yesterday our laundry was picked up and we later saw it in a pile by the river, where it was being washed by hand, then hung out to dry on a barbed wire fence surrounding a nearby farm—it all came back clean, dry and neat. That evening, after a quick bath in the river, we ate freeze-dried pasta primavera and empanadas for dinner, then Kathleen and I enjoyed a family video call with our daughters and son-in-law; Danielle and Jay in Boston and Amy in Moorea, French Polynesia, 2,000 and 5,000 miles away, respectively.
Back at the church, I read by headlamp until I fell asleep, with my rechargeable fan pointed directly in my face. This fan has become one of my best friends, and has run all night, every night, since leaving La Ceiba.
Saturday, Feb 28: Day 6 of the clinic started off much like the previous days. Breakfast was scrambled eggs and leftover empanadas (delicious with Honduran honey!). Like yesterday, I was not at my best, as the heat and humidity wore on me, I was itchy from dozens of chigger and mosquito bites, and frustrated that their wasn’t enough general helper work to go around. Chicken soup for lunch and some electrolyte powder in my water helped my attitude and I tried to stay focused on the mission. My problems were temporary, and paled by comparison to the people coming to the clinic. We saw several children with neurological and developmental disorders, including a four-year-old boy who weighed 96 pounds and had a droop on one side of his face.
Our day’s movements were routine and predictable, cycling between the church, kitchen, clinic and river. On Google Earth, I calculated that since arriving here six days ago, I had not been outside a rectangle of approximately 200 x 700 feet, an area of about three acres. We ate local food again for dinner, washed down with a cold beer from the village store, which has a solar-powered refrigerator, and the second bottle of gifiti rum from Puerto Lempira—both of these helped cheer me up too.
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| You Are Here. The river is at the lower left, the church/dorm is the red-roofed building to the left of the pin, the clinic is the L-shaped white structure below the pin and the kitchen/dining hall is the dark brown square in the middle-upper right. |
Sunday, Mar 1: Just about everyone said that they are now falling asleep and waking up earlier, as our body clocks became more aligned with the sun. Here in the tropics (we’re at about 15 degrees north latitude), the sun’s travel is more perpendicular to the horizon, resulting in little twilight and about 12 hours of daylight year-round. Today was scheduled as a half-day, and the crowd was smaller, as people spent time at church and with family, Beth examined a baby that she delivered a year ago, and the family named the boy after Evan, her and Mike’s son and our teammate. During our stay, we also met Hilario’s son Del, named after Dale, our team leader, and learned of at least one another local child named in honor of an IHS volunteer. We closed the clinic around 12:30 PM, after Mike, Lucas, Bonnie and Seth returned from a house call to see an elderly man who was too ill to rise from his hammock.
After lunch, we walked about a mile to the neighboring village of Blibli Laya (named after a fish found in the nearby creek), where Hilario and his family lived. After crossing the river and hiking on intersecting trails through jungle and farmland, we toured Hilarios’s home, school and church, where a group of children serenaded us with a song in Miskito.
After our outing, we had free time—Kathleen and I swam in the river, a few walked upstream to a larger swimming hole, while others caught up on e-mail, messages and reading. The afternoon was interrupted by a man showing symptoms of an allergic reaction, and Beth, Bonnie and Seth, walked across the soccer field, with a game in progress, to see him—it turned out the man was Amanis, our water carrier. Kathleen joined them, making do with what was available in the pharmacy, and he was stabilized.
Our after-dinner discussion focused on patients that had serious or complicated conditions, especially those who were sent to the hospital. Most every condition that we saw was treatable—even leprosy—but often required long-term care, multiple medications and coordination. Some of the villages had nurses, including Lisangnipura, but they kept limited hours and we heard that they could not be relied upon to track follow-up care. It was hard not to feel down, knowing that most of these difficult cases would not get what that they needed after we left.
Monday, Mar 2: We had a lot of leftovers after breakfast and distributed them to our village volunteers, who eagerly accepted any food that we offered during our stay. It was Day 8, our last of the clinic, and at least 20 people were waiting when we opened at 8:00 AM. There was a big glasses giveaway, as we had plenty left and word got out. Five people were referred to the hospital in Puerto Lempira for various conditions, and by 1:30 PM, all patients had been seen and we wrapped up the clinic and began packing up after lunch. Part of our group visited Calero’s house and small parish in the village, while I helped Kathleen inventory the remaining drugs in the pharmacy, finishing at 5:30 PM, 15 minutes before sunset. We had no time for a river bath without subjecting ourselves to hordes of mosquitos, so we went to dinner in our sweaty work clothes. At our final meal together in Lisangnipura, Dale, Mike and Hilario said a few words to the team, thanking us for our efforts. Hilario emphasized that nobody but IHS volunteers came to La Moskitia to help his people, not even the Honduran government, and his heartfelt sentiments were especially moving. After dinner, Morfy organized and DJed a dance party at the clinic, with lively Honduran music coming out of a large portable speaker. The IHS volunteers took the lead in dancing, with a few locals joining in, but most watching. Apparently, after we left for the church dorm, the villagers got into the spirit and danced for quite a while.
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| Front row, L to R: Hilario, Kathleen, Tony, Beth, Mike, Lucas, Morfy. Back row, L to R: Evan, Lynn, Seth, Bonnie, Sharon, Veronica, Dale, Amanis. |
Tuesday, Mar 3: After waking up, we packed our personal gear and finished stowing clinic and kitchen items for the return to Puerto Lempira. Kathleen passed out deworming pills to the IHS team members, then she and I departed on the first of three trucks for the three-hour drive back to Puerto Lempira over the dirt road and 11 bridges. After our first shower in more than a week, several of us grabbed lunch at Coffee Roll, enjoying ice-cold drinks and a passing downpour. We walked back to the catholic church, arriving at the same time as the third truck from Lisangnipura, which suffered a flat tire, slowing them down enough to get caught out in the rain. At the compound, we chatted with a three-person IHS group that did cervical cancer screening in Para Ella. Due to a high-risk human papillomavirus (HPV) strain, low public awareness and a lack of health care, cervical cancer is the leading cause of cancer deaths in Honduran women and a growing public health problem.
Later, Kathleen, Beth, Mike, Bonnie and Seth walked to the Puerto Lempira Hospital to tour the facility and check on our referral patients. Sadly, they learned that many of them, including the two leprosy sufferers, had been sent home by the on-call physician without any further treatment; another depressing dose of reality on health care for the poorest of the poor.
In the evening, we piled into a truck and braved another bumpy road ride for a team dinner at Caratasca Breezes Bar & Grill, a newer waterfront restaurant with a nice dock, man-made beach, pool table and dining areas over the water. The breeze coming off the lagoon felt lovely as our 14-person group waited for our food. More thanks and farewells were said, and we lingered until almost 10:00 PM, enjoying the trade winds and attractive sandy grounds.
Wednesday, Mar 4: I slept well, until some early morning rain showers woke me up before the church bells 50 feet away began ringing at 6:20 AM. Most of our group returned to Coffee Roll for breakfast, then more rain fell as we waited for the truck to take our luggage to the airport. When we checked in at the airport, we found to our delight that our luggage was under the weight limit and nothing had to be left behind, but to our dismay, two of our team did not have reservations on the flight. Thanks to John and Bill, our Puerto Lempira program directors, one of those affected was given an open seat reserved for medical emergencies (there weren’t any today) and the other was booked on a later flight that day—otherwise, they would have had to stay behind until Friday. The 1.5-hour flight to La Ceiba was uneventful, with a terrific view of the Honduran coast and Caribbean Sea out of my starboard-side window. We were met at the airport by another IHS-arranged driver, then returned to the Gran Hotel Paris around 2:00 PM. We showered, read, relaxed and napped on our king-sized bed in air-conditioned comfort, appreciating these luxuries. We met Bonnie and Seth for a drink by the pool, staying under a covered table as more rain fell, then had dinner with them, Winnie from the Para Ella team and John, the IHS Program Director. We wouldn’t fly home until Friday and were discussing what to do the next day when John suggested contacting Frances, the group’s local travel agent. Kathleen texted her and before dinner was over, we had a plan to go sightseeing the following day.
Thursday, Mar 5: We set our alarm for 5:30 AM, got to breakfast at 6:30 sharp when the buffet opened and met our driver at 7:00 AM for the 45-minute drive east to Sambo Creek, where we checked in at Tourist Options (https://touristoptions.com/). From there we rode a 20-foot, open launch out to Cayos Cochinos (Hog Islands), a small archipelago and marine protected area 16 miles northeast of La Ceiba. The group consists of two volcanic islands and 13 coral keys, with a total land area of less than one square mile, no cars and a population of around 100, mostly indigenous Garifuna. The islands are part of the Meso-American Barrier Reef, the second-longest reef system in the world, which stretches from here to the tip of the Yucatan Peninsula in Mexico. The Garifuna, descended from West African, Carib and Arawak peoples, originated on St. Vincent in the southeast Caribbean and were exiled by the British to Roatan in 1797 following 40 years of conflict. Today, about 100,000 Garifuna live in the Bay Islands and Caribbean coast of Honduras, mostly in small fishing villages and still speaking their native language, along with Spanish and English. Map link: Cayos Cochinos
Our first stop was at a research station, where we watched a short orientation video, then we went to a second island for a jungle hike in search of the boa rosada, an endemic pink boa constrictor (we didn't see one). At a third island we went snorkeling, then it was off to Cayo Chacahuate (“twin island”) for lunch, where we strolled through the crowded Garifuna village and along the white sand beach, watching frigate birds soar in the trade winds. The weather was warm and beautiful and the clear turquoise waters were inviting, although it was a rough ride back to Sambo Creek in 3-4 foot rollers. Kathleen was on the side with the most spray and got the worst of the it, then we both got wetter exiting the boat in the surf. We were so soggy that our driver wouldn’t let us in the car until he put garbage bags on the seats.
Back in La Ceiba, we cleaned up and dressed for a farewell banquet hosted by IHS. Members from all five teams were present, but many folks had already departed for home or vacations on Roatan Island and our Lisangnipura team leaders, Dale and Lynn, were still in Puerto Lempira wrapping things up.
Friday, Mar 6: On our last day in Honduras, we again set an early morning alarm to catch the 5:30 AM shuttle from La Ceiba to San Pedro Sula Airport. There were seven of us from various teams aboard, including Claudia, another Honduran dentist, who was going straight to work this morning. So much had happened since we traveled this road two weeks ago, and we reflected on those new experiences and savored the lush, green countryside one last time. The four-hour drive, slowed by construction and one accident, actually passed fairly quickly. At the airport, we said our goodbyes, checked in, and lunched on baleadas, a traditional Honduran dish similar to a soft taco or quesadilla before boarding our plane.
Our arrival in Atlanta was delayed by thunderstorms—we circled the airport for 30 minutes before landing, then waited almost two hours for our luggage, which was held up in a full ground stop on the tarmac as more severe weather rolled through. When our suitcases finally arrived, they were soaking wet, and we only handled them for a few minutes before passing through customs and rechecking them on our domestic flight. People with close connections were stressed, although we had a long layover planned and had time to get a sit-down meal in the airport. At our gate, we learned that our flight to Minneapolis-St. Paul was delayed three hours; in fact, most flights in the terminal were delayed due to weather and the gate areas were a mass of anxious people and overworked Delta Airlines agents. At 11:45 PM, we began boarding our plane after the crew finally arrived, although I immediately noted that there were no pilots, only flight attendants. We sat on the plane for 30 minutes before being updated that our pilots were stuck on another plane waiting for a gate to open up and as soon as they got there we’d be on our way. After another 45 minutes, it was announced that the air crew had “timed out,” meaning that they’d reached their federal maximum number of working hours and could no longer legally fly, and our flight was canceled. We grabbed our bags, left the plane and joined the throng of confused, frustrated and angry passengers in the gate area, as ours wasn’t the only flight that was canceled. To Delta’s credit, they offered us a choice of flights the next day, a meal voucher, hotel room and Uber fare there and back, all done through the Delta app. It was a challenging time and a very late at night, but everything was managed without having to wait in line to see a ticket agent or wait on hold to talk to a customer service representative. We booked a mid-day flight the next day, picked a hotel and then headed for the ride-share pickup point, along with hundreds of other stranded passengers. We had to wait about 20 minutes for an Uber, then rode a half hour to our hotel in the suburbs, checking in a little after 2:00 AM. It was crazy, but sure beat sleeping in the airport, and it didn’t cost us anything but time. We fell asleep around 3:00 AM, almost 23 hours after waking up in Honduras the previous morning.
Saturday, Mar 7: Kathleen and I both woke up around 6:30 AM after only a brief rest, then walked to breakfast at a nearby Cracker Barrel restaurant, where we cashed in our meal voucher. We Ubered back to the airport to try again, and boarded our plane for home. Our flight was full, with 133 seats on the plane and 28 passengers on standby—only two or three of them got seats. Our checked bags had been sent ahead on an earlier flight and were waiting at the baggage services area in Minneapolis; they were still wet from last evening’s thunderstorm. Kathleen’s twin brother Lars picked us up and drove us to our condo in St. Paul after 19 days away from home.
I feel fortunate to have been able to take part in this mission. We love to explore, and this was a very different type of travel and one that I’d never experienced before. Getting out of your comfort zone is healthy and there was an admitted satisfaction and sense of adventure in successfully venturing into one of Central America’s last frontiers and a region that the U.S. government avoids and the Honduran government neglects.
Kathleen is all-in, and planning to return next year—I am undecided. The pain in my right hip and still-healing chigger bites say No, but these nuisances will pass with time. In the pro column, there is no better feeling than helping people, Kathleen and I are definitely closer after this powerful shared experience, and the staggering need and heartbreaking poverty of the region make us count our many blessings. And I didn’t contract malaria or acquire a parasitic hookworm, both (ir)rational fears of mine.
I will definitely say that the folks at IHS made it pretty easy for a first-timer. If you’re reading this and on the fence about whether or not to go on a mission, know that there are friendly, dedicated and experienced people supporting you, who will make it possible to just book your travel and show up, if that’s where you’re at.
Hopefully, more than 900 Miskito villagers are better off for our having been there. Here are some more of them:
