Wednesday, August 28, 2019

Thoughts on medicine in Honduras

A large part of the global health experience lies in learning about other countries’ medical systems. We were fortunate enough to have a few doctors from Honduras working alongside us, including Dr. Fabricio, who shared with us some humbling statistics about medical training in Honduras. Honduran doctors get a vast wealth of experience during their residency programs-- Fabricio had delivered thousands of babies in his training, including one night shift during which he delivered 22! I feel like our program has a good share of OB training in comparison to many others here in the US, but I will likely deliver a mere 70-80 babies by the time I finish residency. I was lucky enough to sit next to Fabricio while seeing patients each day in clinic, and he was so kind, knowledgeable, and thorough in caring for each person he saw, and understood the dynamics of barriers to healthcare in the community in a way that I certainly did not grasp. 

Honduras has a total of 16,000 fully trained doctors, but only 6,000 of them are currently employed providing direct medical care. This is largely due to the lack of resources and infrastructure to support them. And yet Honduras clearly has a desperate need for more medical services for its people. Part of this gap is served by foreign medical brigades like ours-- 40% of health care in Honduras is provided by international medical organizations. It was hard for me to reconcile this fact with the number of doctors who were out of work-- it seemed like if all trained Honduran doctors were employed in health care, then the healthcare gap would largely be closed. Unfortunately, the barrier seems to be medical supplies and equipment, not necessarily healthcare personnel. In this, we were able to aid by bringing down medicines, vitamins, and basic healthcare supplies. However, as with many international missions, it seemed a short term solution to a long term problem, though we tried our best to connect patients to longer term care when indicated. It was humbling to think of all the training the Honduran doctors had and all the energy, passion, and sleepless hours they put into it-- and then that ultimately, many of them are unable to serve the patients they love, many of whom still desperately need medical care. I left feeling grateful that I am able to serve my patients here with the abundant resources that we have, and wondering what steps can be taken to ensure more equal access to healthcare supplies across the globe, specifically in Honduras. I don’t have much of an answer yet. I don’t know if our bringing supplies down is hindering or helping the process-- it certainly helps meet a direct immediate need, but would the Honduran government feel more pressure to build a more complete healthcare infrastructure in Honduras without the presence of foreign medical aid? It’s hard to know for certain. In the meantime, I will appreciate the ease I have of getting a patient in to see a specialist here, or even running simple lab work, and remember the gratifying patient encounters and small help we were able to provide, albeit briefly, in Honduras.

Joanna Ingebritsen, R3, KP Napa Solano

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