10 April 2014

Honduras Health Centers: San Nicolás

We went to the health center in San Nicolás on a cloudy Wednesday morning. It was toward the edge of town, off of a cross street from the main paved road. The health center here is a CESAMO, a health center run by doctors, as opposed to a CESAR, which is run by nurses. When we got there, we found that the two doctors who run the health center were on vacation. In their place was Guillermo Flores, a capable nurse who was heading the center for the time being (and looking very busy doing it). He had little time to talk, but in the moments he had, he gave us a fluid narrative of water-related health in San Nicolás.

He emphasized how interconnected the problem is, with both social and practical factors. For reasons of poverty, people are not able to afford bottled water, so they will use untreated tap water, and sometimes river water. Water from rivers is especially dangerous due to contamination resulting from poor sanitation. Further, people store rain water during the dry season, which provides a breeding ground for mosquitoes that carry dengue and malaria.

Sr. Flores was quick to point out that, while water is clearly a problem, health problems like diarrhea have a broad array of sources. He cited, for example, that parasitic worms can be transmitted from the soil into the body through bare feet. Likewise, food can also be a route for infection, and it is difficult to differentiate.

In all, he was excited about the treatment plant, and felt that it would be a benefit to the community. He cited many cases of Hepatitis A due to water contamination, as well as less visible effects. For example, mothers preparing formula for their babies will sometimes use dirty water, causing them to fall ill. Hearing about the many issues related to the lack of clean water, we are delighted that the AguaClara treatment plant was recently inaugurated in San Nicolás.

The social aspect of health seems to be taking on greater importance in the approach of Honduran health workers. It seemed that all of the health centers we visited had active outreach and education programs, with San Nicolás being no exception. As we were leaving, Sr. Flores asked us if the people of the municipality had welcomed us well. We were a little surprised by this question, but he explained that the health center puts on a local television program to educate the community about various health issues. Most recently, they had aired a program on welcoming foreigners. If the incredible welcome we received in San Nicolás had anything to do with the television program, then we have good reason to be exceptionally hopeful about the effect of the program on the future of health in San Nicolás.

- William Pennock