Clinicas (by Todd)
Being very interested in the matter of medical care here in Honduras, I've been busy the past two weeks familiarizing myself. The nearest hospital is in Tegucigalpa, so much of the primary health care is administered through "clinicas" - health care clinics. They can't provide specialists or surgery, but they can give consultations and provide medicines.
There are about half a dozen private clinics in Talanga, but, since many people can't afford those, I've visited three clinics that try to minister to the general population.
THE CENTRO DE SALUD (in Talanga)
The Honduran government, via the ministry of health, sponsors "Centros de Salud" (Health Centers) in most major towns. As it turns out, the Centro in Talanga is in charge of all the Centros in the area. We took a tour with the director, who's also the director for the other Centros in the area, two Wednesdays ago.
Centros have varying personnel, depending on the size of the town where they are located. Some of the smaller ones have only nurses. The one in Talanga has some 4 or 5 doctors and a dentist, in addition to nurses and support staff. Many of the doctors are just out of medical school; Honduran medical students are required to do one year of public service upon graduation.
The doctors provide health care and medications for 1 Lempira (basically for free). The problem is that there is very little money for medications, and they frequently run out. A very common complaint is that the Centro will give a prescription, but the patient doesn't have the money to actually buy the medicine. Another example: the Centro here has a half-constructed maternity ward that has been sitting for several years. The big problem is not actually the money to build the ward, but the money to pay the personnel once its constructed. So it sits unfinished.
To reach to communities where there is no Centro, the Centro de Salud has representatives who can provide very limited medications, and refer people to the Centro in Talanga. In addition, the Centro sponsors public health educators, who work in various communities educating people about healthy behavior.
LA CLINICA SOLIDARIA
I thought this clinic was a really neat idea. It was started less than a year ago by a pharmacist from Spain, who was working at an orphanage and left to help the public health sector.
The clinic is private, but non-profit. The basic idea is to provide self-sustaining, quality health care. Everyone who visits is charge a flat fee of 70 Lempiras ($3.50 in US dollars, although it goes a lot farther here). With that 70 Lempiras, they are given a consultation with a physician and any medicines they need (that the clinic can provide).
What is really neat is that with that 70 Lempiras per patient (actually, there are some types of visits that cost more, but that's the basic), the clinic is self-sustaining; it pays for medicines, doctors, and electricity. And 70 Lempiras is very cheap compared to the private doctors.รง
It was very high-tech - all the medical records and pharmacy orders computerized. New developments (building, technical machines, etc.) are paid for with donations from Spain. But everything else is self-sustaining. A really neat idea, I think.
And here's the neatest part. It is called "Solidaria" (solidarity) NOT because the doctors are in solidarity with the patients, but because the patients are in solidarity with each other. As the director explained it, some patients cost the clinic more than 70 Lempiras. But they make it up because other patients cost less. In essence, some people help pay for the health care of others, even though they don't realize it! I thought that was a fabulous idea.
Of course, there are lots of people that can't afford the 70 Lempiras. But for what it's trying to do, I think it does a very good job.
THE CLINICA IN GUAIMACA
The last clinic we visited was a free clinic run by the Catholic Church in Guaimaca, a neighboring town. It was started by a nun who is also a nurse practicioner about 3 years ago.
Basically, they have a team that is a combination of Hondurans and long-term (1 year or more) volunteers from the States. The one doctor is a Honduran woman. The money and medications are all provided for by Catholic parishes in the States that are connected with the parish in Guaimaca.
The clinic sees fome 40-50 patients a day. They also take medical brigades into the aldeas (mountain towns) every so often - particularly when they get a big short-term volunteer group.
The nun in charge was a wonderful guide. She had lots of pearls of wisdom about health care, two of which I'll share.
First, that one of the big challenges here is making long-term changes towards healthy behavior. She says they see lots of patients who come in every three months with the same problem because they persist in unhealthy behaviors.
Second, "en Honduras no falta doctores, falta la 'con que hacer'" (Honduras doesn't lack doctors, it lacks the 'with what' [ie supplies] to work).
The Centro de Salud has the same shortage of medications, so they help a lot by being able to provide medications for free. It was really neat to see the positive impact an organized faith group can make.
There are about half a dozen private clinics in Talanga, but, since many people can't afford those, I've visited three clinics that try to minister to the general population.
THE CENTRO DE SALUD (in Talanga)
The Honduran government, via the ministry of health, sponsors "Centros de Salud" (Health Centers) in most major towns. As it turns out, the Centro in Talanga is in charge of all the Centros in the area. We took a tour with the director, who's also the director for the other Centros in the area, two Wednesdays ago.
Centros have varying personnel, depending on the size of the town where they are located. Some of the smaller ones have only nurses. The one in Talanga has some 4 or 5 doctors and a dentist, in addition to nurses and support staff. Many of the doctors are just out of medical school; Honduran medical students are required to do one year of public service upon graduation.
The doctors provide health care and medications for 1 Lempira (basically for free). The problem is that there is very little money for medications, and they frequently run out. A very common complaint is that the Centro will give a prescription, but the patient doesn't have the money to actually buy the medicine. Another example: the Centro here has a half-constructed maternity ward that has been sitting for several years. The big problem is not actually the money to build the ward, but the money to pay the personnel once its constructed. So it sits unfinished.
To reach to communities where there is no Centro, the Centro de Salud has representatives who can provide very limited medications, and refer people to the Centro in Talanga. In addition, the Centro sponsors public health educators, who work in various communities educating people about healthy behavior.
LA CLINICA SOLIDARIA
I thought this clinic was a really neat idea. It was started less than a year ago by a pharmacist from Spain, who was working at an orphanage and left to help the public health sector.
The clinic is private, but non-profit. The basic idea is to provide self-sustaining, quality health care. Everyone who visits is charge a flat fee of 70 Lempiras ($3.50 in US dollars, although it goes a lot farther here). With that 70 Lempiras, they are given a consultation with a physician and any medicines they need (that the clinic can provide).
What is really neat is that with that 70 Lempiras per patient (actually, there are some types of visits that cost more, but that's the basic), the clinic is self-sustaining; it pays for medicines, doctors, and electricity. And 70 Lempiras is very cheap compared to the private doctors.รง
It was very high-tech - all the medical records and pharmacy orders computerized. New developments (building, technical machines, etc.) are paid for with donations from Spain. But everything else is self-sustaining. A really neat idea, I think.
And here's the neatest part. It is called "Solidaria" (solidarity) NOT because the doctors are in solidarity with the patients, but because the patients are in solidarity with each other. As the director explained it, some patients cost the clinic more than 70 Lempiras. But they make it up because other patients cost less. In essence, some people help pay for the health care of others, even though they don't realize it! I thought that was a fabulous idea.
Of course, there are lots of people that can't afford the 70 Lempiras. But for what it's trying to do, I think it does a very good job.
THE CLINICA IN GUAIMACA
The last clinic we visited was a free clinic run by the Catholic Church in Guaimaca, a neighboring town. It was started by a nun who is also a nurse practicioner about 3 years ago.
Basically, they have a team that is a combination of Hondurans and long-term (1 year or more) volunteers from the States. The one doctor is a Honduran woman. The money and medications are all provided for by Catholic parishes in the States that are connected with the parish in Guaimaca.
The clinic sees fome 40-50 patients a day. They also take medical brigades into the aldeas (mountain towns) every so often - particularly when they get a big short-term volunteer group.
The nun in charge was a wonderful guide. She had lots of pearls of wisdom about health care, two of which I'll share.
First, that one of the big challenges here is making long-term changes towards healthy behavior. She says they see lots of patients who come in every three months with the same problem because they persist in unhealthy behaviors.
Second, "en Honduras no falta doctores, falta la 'con que hacer'" (Honduras doesn't lack doctors, it lacks the 'with what' [ie supplies] to work).
The Centro de Salud has the same shortage of medications, so they help a lot by being able to provide medications for free. It was really neat to see the positive impact an organized faith group can make.
posted by at 10/20/2005 04:52:00 PM
1 Comments:
Dear Todd, thanks for your nice and interesting comments about our clinic. We agree that many people can't afford 70 lempiras. We are working on that. We lowered to 35 lempiras for one day and it was very succesful. However at the present moment we are not able to do this every day. Have you seen our web page www.clinicasolidaria.org?
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