Honduras Spends 80% Less Than the Rest of the World on Health Care

Status of Healthcare in Honduras 

The Archivos de Medicina published an article on the situation of health care in Honduras.  The article was published in Spanish in 2016.  In 2017, it was translated into English, and published in Archives of Medicine.  (links to the articles are below)

Some stricking facts from the study are:

Per Person Spending on Health Care

Honduras spends $101 per person per year on health care. ***

The average in Latin American and the Caribbean is $392 per person.

World average is $628 per person.

Organization for Economic Cooperation and Development (OECD) nations spend $2,880 per person.

*** Shoulder to Shoulder, under its contract with the Honduran government, receives $19 per person per year to provide medical care.

Availability of Medical Providers

The capital city (Tegucigalpa) had 23.8 doctors per 10,000 inhabitants.

The Department of Intibuca (where Shoulder to Shoulder provides services) has 2 doctors per 10,000 inhabitants.

None of the 18 departments in Honduras meet the minimum indicator of 25 physicians per 10,000 inhabitants as indicated by the regional human resources target.

The unemployment rate among registered doctors is 46%.

Conclusions

  • Honduras suffers from a nondefined public health policy;
  • Epidemiological surveillance systems are almost non-existent;
  • State payments to decentralized entities are not timely, (there are delays of up to one or two years);
  • Medical fees have been frozen for more than ten years;
  • There is corruption by government and private managers; and
  • The economic deficit of the public network of Hospitals exceeded 600 million Euros (33,000 medical centers, laboratories and hospitals run the risk of disappearing).

Links to the articles:

Situación del Sistema de Salud en Honduras y el Nuevo Modelo de Salud Propuesto

Situation of the Health System in Honduras and the New Proposed Health Model (English version)

HEALTH SERVICES PROVIDED



EXECUTIVE SUMMARY 
Every month, the Shoulder to Shoulder Coordinator of Healthcare Services — Dr. Gloria Castro — sends a report to the Ministry of Health which details the Health Services provided in the previous month. StS provides healthcare to over 70,000 people, in seven (7) municipalities.  The amount we receive from the government is not sufficient.  Receiving only $19 per person leaves us with a huge deficit each year. 

These reports are now posted on the STS website.

Click HERE to read them.    
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When Children Are Engaged, Children Prosper

By Mariela Rodriguez – Assistant Director

Teachers from many kindergartens gather together

Teachers from many kindergartens gather together

We called it the “Kindergarten project.” In early 2018, as a new school year was beginning in Honduras, a parent approached to say that their child’s kindergarten teacher was interested in being part of our computer-assisted learning initiative. At the time, our education programs focused on grades 1-9. Nonetheless, we decided to meet with the teachers.  At the end of the meeting, our team offered to help fund, along with their parent association, half a television set to project English learning programs to an entire classroom of children. Our vision was for the kindergarten to pay us back and offer half-funding to another school in the future.

In September, we visited and checked-in on the project and were amazed at how the kids interacted with the program through the television screen —  singing songs in both English and Spanish and learning to pronounce the sound of the English letters (see video).

In exchange for the assistance they received from Shoulder to Shoulder, we asked them to host a meeting with kindergarten teachers from other local towns to share their advances in the project. In mid-November when the meeting took place, teachers from 5 different kindergartens – representing 4 towns were present. The meeting was a success, and a number of teachers expressed interest in joining next school year!

We as an organization are very thankful and impressed with the success of our Kindergarten project and seeing the enthusiasm and gratefulness amongst the parents and the teachers causes us to also be excited to expand next year.

We saw that empowering community members was fruitful for both parties. 

We’ve seen that finding community motivation, support and initiative is like hitting the jackpot.

Watch video: https://drive.google.com/file/d/1-dlFUJ7CS3TOxPU_EEEZtg7coMrvrg4Z/view

The Other Side of the Mountain

By Jan Tepe, DDS – Dentist who has traveled to Honduras for 20 years

Note:  Even though Dr. Jan Tepe is writing about DENTAL services — the children she writes about are the same children who are in StS’s nutrition program.

It was a trip I’d wanted to do for nearly ten years. We had heard about a community in the area of San Marcos de Sierra that was “the poorest of the poor”. We’d already established school dental health programs in Santa Lucia and Concepcion and wondered what could be next. I mentioned the possibility of visiting this community, the poorest of the poor, called Delicias, to Laura Manship some months ago. She herself had made the hike and cautiously discouraged us from trying to get there. It’s a long and difficult hike, up one side of a mountain and then down the other side. We discussed the obstacles of the hike with our group – two dental hygienists, the Honduran dentist and her assistant, a public health dentist, and our two drivers/guides. Everyone agreed to the plan. The trek began at 4:00 am when the truck arrived to meet us near the square in Concepcion. After a half hour or so on the main road we turned onto the dirt road. For the next hour we bumped and bounced over ruts and rocks, up hills so steep I didn’t think it was possible for a vehicle to climb. So this is what four wheel drive is for! In 20 years of travel to Honduras, these roads were as bad as any I’d ever seen.

Eventually, the road ended and the two trucks were tucked in close to an embankment. We donned our backpacks filled with dental supplies and water and set out. The path up begins somewhat wide with sharp drop-offs to the valley. Ahead of us was a Honduran woman in a dress and sandals carrying a box that was held by a nylon net looped over her forehead and hanging down her back. Our group spread out, each of us stopping as necessary to catch our breath and admire the spectacular scenery. The sun had come up and it was a beautiful day. The woman disappeared from sight and presumably took a shortcut too steep for us, but we later saw her on the other side of the mountain. Up, up, up, through a narrow ridge with scrubby foliage where the terrain fell off on both sides.

After 2 hours we were rewarded with the sight of the village. This isn’t your normal village. We saw three buildings – a public health clinic, a school, and a small pulperia. People in this area live tucked away, far from one another. We set up our supplies outside the school and waited until the children and their parents arrived. There is no electricity in Delicias and little contact with the outside world. The people are neat and clean with little girls wearing dresses and mothers wearing homemade dresses and sandals. Dra. Idalia gave a talk, discussing how to brush teeth, why we brush teeth, diet, and what we planned to do.

And what exactly did we plan? Well, after each child had brushed their teeth, we examined their teeth and applied a material called silver diamine fluoride (SDF) to areas of decay. SDR kills the bacteria in the cavity and stops the decay. Sometimes this require two or three applications. The downside is that the areas of decay turn black. The upside is it is painless, requires no injection, and the teeth are saved. This material in gaining popularity, especially in developing countries. After seeing first hand the difficulties in simply getting to this community, we understood why these people cannot come to our clinic and also why it would be impossible to get portable equipment to them.

The kids and parents were great. Of the 50 or so children that we saw, only one little guy about 4 years old screamed his head off. The others patiently waited in line and then compliantly opened their mouths while we strange looking, tall, pale people dabbed stuff on their teeth.

Shortly before noon we left Delicias to do the hike in reverse. If up the mountain was strenuous, down the mountain was scary, with steep switchbacks every 15 feet or so and loose scree. Walking on marbles, down a playground slide would describe it. The way back was no easier, but somehow the way home always seems shorter. We have a new appreciation for the lives of the people on the other side of the moutain.

Jan Tepe, DDS, in Delicias, Intibuca, Honduras

Jan Tepe, DDS, in Delicias, Intibuca, Honduras

Delicias, Intibuca, Honduras

Delicias, Intibuca, Honduras