COVID-19 in the hills of Copán

I am an introvert, but this isolation is a bit difficult.

Yet I think it might not be as hard here as it is in parts of the US – at least for me, privileged as I am. I have food, water, electricity, internet – and neighbors. I have gas for cooking (thanks to the kindness of our pastor) and tomatoes (thanks to a project of a friend here in Plan Grande). I’ve also talked over the internet with two friends in the US and Palestine. I have flour and yeast and so can bake bread.

Sure, there are difficulties. I have few vegetables, no cereal or granola, and I can get to Dulce Nombre once a week. There are no restaurants or grocery stores that can deliver take-out or groceries. There’s not even a good grocery store in Dulce Nombre. I am rationing my yogurt and cheese since these are hard to come by in Dulce Nombre. 

I do have water and I can get purified water from a nearby small store – and I’ve had young guys carry the large bottle back for me – at least part of the way.

I also have internet, which may or may not be a curse. In a desire to connect with folks as well as to get information on what is happening, I spend too much time on the internet and, to avoid rage, I have to avoid reading any number of posts, especially about “leadership” in the US.

It's also been very hot - in the 90s - and extremely dry. I waked to the parish coffee field this morning and some of the plants look wilted and there are a lot of yellow leaves.

But what’s happening here. The statistics here are probably misleading. As of last night, there have been 494 cases of positives from tests. 46 have died and 29 have recovered. There are a number of people hospitalized and some in ICU, but it appears that many are quarantining at home.

The majority of cases have been in the San Pedro Sula area with the Tegucigalpa area not far behind. There has been one case here in the department of Copán, but the woman had visited another part of Honduras. She was hospitalized in the Santa Rosa hospital but recovered and returned home, to the welcome of neighbors.

The ratio of deaths to cases seems rather high – almost 10%. Yet there have been so few persons tested that the ratio may not be as high in the general population, though my guess is that the situation is extremely serious in parts of the north coast around San Pedro Sula. There are private firms that will be beginning to test this week and we may have better statistics.

The government has taken this fairly seriously. We have virtual lock down. We can go out to a neighborhood small store (tienda or pulpería) but we can’t circulate, especially in vehicles, only once a week. Then we can go to banks or grocery stores at certain hours. We senior citizens (over 60) have an hour designated only for us in the morning but still the lines are long.

If we go out, we have to have masks – and it appears that the government is now giving out masks! The vendors are supposed to be masked and gloved, but I have seen some vendors without gloves and some even without masks. I just saw a facebook post from a private group that is bringing goods to poor people in the municipality of Dulce Nombre. I could only see one person wearing a mask.

There is no public transport and so it is difficult for people in the countryside to get to the larger towns for purchases. The government, through the municipalities, is distributing basic food supplies and some soap and bleach. The idea is to get this to the neediest, though some are complaining that not everyone is getting something.

My experience in the municipality where I live, Concepción, Copán, is that this is not easy. First of all, there is the temptation to use the aid in a partisan way to support the parties in power. I have seen photos of politicians and military personnel distributing the aid in other parts of the country. Here, municipal workers are doing it and seem to avoid a partisan approach. (See my previous post.) Secondly, the people are so used to getting stuff free from the government that some look upon the aid as a gift from politicians. When I accompanied the disbursement two weeks ago, when people said thank you, I tried to tell that that this is what is due them. Thirdly, an issue will be availability of goods.

But a very real issue on the national level is the corruption. It seems that some goods were bought at twice the market price. That probably means that someone is making a killing – and I use that word deliberately – in this crisis. The government supposedly cracked down on the most obvious case (brought to light by an alternative communications network). But the problem still remains.

The situation of medical workers is precarious. There are reports that they are not getting the bio-security resources they need. A lot of money has come into Honduras, but the question is where is it going.

There are a few bright spots.

Yesterday a large medical brigade from Cuba arrived with Cuban doctors and nurses, as well as Hondurans studying medicine in Cuba. From what I can determine, they will be helping in the most desperate areas.

Another surprise is the caliber of the nightly press conferences of government officials. They come across as professional, though one must keep a critical stance in terms of what they are saying.

Last night I watched ten minutes of the Honduras president’s address, explaining what was being done. It was professional. No rants, no blaming someone else, no threats to opponents. Though I am very critical of the politicization and the militarization and the concentration of power that his government has brought, I found that he was composed. What a welcome relief to what I’ve seen of the president of a country to our north.

Where will all this go?

My guess is that we’ll be on curfew for a few more weeks, at the very least. It might even be a month or two.

My concern is that people will get sloppy in terms of prevention of spread of COVID-19. The practice of social spacing and of wearing masks is not taken as seriously as I think it should be, and not only by the poor. I fear some people are cutting corners and may be opening ourselves to endangering others – if not by our actions, possibly by the example that our actions seem to give that make social precautions seem less important.

In the meantime, I read, I write, I cook, I pray.

And I wait – in hope.

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UPDATE: I found out that there have been 2535 as of April 22, 2020.

Winning hearts and minds, Honduran style

The military had a medical brigade at the Candelaria Health Center today. 

I did not stop and enter to see what they were doing. I didn’t want to be seen there, since it could be interpreted as support. As the sign read, general medicine, dentistry, ophthalmology, pediatrics, psychology, cytology, as well as legal advice and hair styling.

Call me cynical, if you want. But, in a society that is increasingly militarized, in a country where there have been scores of killings and excessive use of force by government security forces, as noted in a recent Amnesty International Report, what are they doing with a medical brigade?

During the Vietnam war and during the US-backed Central American wars in Central America, there was a policy of “winning hearts and minds.” The often-repressive governments would send troops to do public projects. This seems very much like a new form of the same.

It seems like a form of psychological warfare to get the people to “feel good” about the military despite the repression.

It almost feels like an extension of the Roman empire’s tactic of pacifying the masses with “bread and circuses.” People came and, according to a poster, were seen by health workers (in military uniform, I presume) for various ailments. They were given medicine and a bag of clothes. There was even an inflated tent that looked like a play tent for kids you’d find at a fast food restaurant.

I have serious reservations about most medical brigades, especially this type.

Without a commitment to the integral development of a public health system, why is the military bringing needed health services to communities where medicine is often scarce?

Without seeking to hire and bring in some of the trained and unemployed doctors and other medical personnel, why is the “security” branch of the government providing needed medical services”

Without an apparent commitment to enhance the capabilities of local health workers, what is an outside group doing here?

Without a commitment to the area and a knowledge of the local situation, what does a group that comes in for a day or two really doing? Is there possibility of medical malpractice, as people come seeking medical help whenever a brigade shows up? See my previous blog post about a US military medical brigade three years ago.

Call me cynical, if you want.

The people need and deserve real medical care, not a band aid approach, especially a band aid approach that seems to try to make them grateful to or dependent on an agency or a political party. Health care is a human right which shoulc not be politicized or militarized.

There are medical groups that do brigades in a very different style. They commit themselves to a place as a way of helping develop the medical infrastructure in that region. They return regularly to that area. They assist local medical persons and medical centers to improve their service to the people.

Most importantly, their major concern is the health and well-being of the people and they try to distance themselves from any partisan political efforts. There is one working this way in our area, thanks be to God.

Where's the medicine? part two

I am concerned about the lack of medicine for the poor. I can buy medicine but most people can't.

Tonight I came across a video:



The Honduras Solidarity Network noted the the 20% cuts in funding to the health system are International Monetary Fund mandates. They content that these mandates are intended to further weaken the system to pave the way for privatization. I have not studied this enough to vouch for this claim, but it sounds somewhat plausible.

They also note that the lack of medicines and medical supplies has been long standing. Part of the more recent lack of medicines stems in part from the IHSS embezzlement scandal noted in an earlier post.

There is a report, however, in Fides, that the government will give out medicines to hospitals and government clinics next week. It will be interesting to see if they arrive at the local clinic - and what medicines and in what quantities.

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If the video doesn't load, you can find it here.

A better life?

A few weeks ago I went with Padre German to a home in Dulce Nombre. The woman who lives there with a family has a nice garden plot around the house. But inside the house was a kit for a drip irrigation system with a brand new plastic barrel for water.

I was surprised because these are not cheap. But then saw that it was a part of the Vida Mejor, a program of aid from the Honduran government.

The government is giving out these kits, but I don’t know how much follow-up there will be or assistance to install the systems.

In the meantime the local health center has no medicine.

Is that una vida major, a better life?

Or is it a way to try to buy the hearts and minds of the people – giving them things, even if they may not really need them or know how to use them?

Today a friend shared this photo on her Facebook page:

Every pregnant woman who comes for a cesarean, please bring

• a set of surgical clothing
• 2 pairs of sterile gloves #7.5
• 2 pairs of sterile gloves #7.0
• 2 pairs of sterile gloves #8.0
• 1 Vicril (suture) 4-0 cortante (?)
• 2 Cromico 2-0 (possibly cat gut sutures)
• 7 Cromico 1-0 (possibly cat gut sutures)
• 1 Vicril (suture) 1-0 redondo (ring style)
• 20 gauzes
• 2 rolls Esparadrapo (adhesive tape)
• 2 syringes 10cc

The note in the cloud reads: Due to the situation of the hospital, thanks for understanding. 

 My medical Spanish is almost nil. If anyone knows how to translate the terms better, let me know and I’ll correct them immediately.

No. I don’t understand.

Money is available for give-aways, but medicines are not available.

I don’t understand.

But I do understand why thousands of Hondurans were out on the streets in the last few days – including a thousand last night in Santa Rosa de Copán. Here's the New York Times report.

UPDATE: Here's a good analysis of the situation by Honduras Culture and Politics.

There are reliable reports that the corruption that existed in the IHSS, the Honduran Social Security Institute, that is in charge of public hospitals and other social services. The ex-director was jailed.

But there are more recent reports that funds were diverted to the political campaigns of the National Party – the party now in power. As a result people have come out on the streets.

What will become of this, I don’t know. But I understand the anger and frustration.

And I know that injustice prevails – and that the poor have no medicine because of corruption and malfeasance.

Where's the medicine?

Recently I visited the rural public health center near where I live. A Honduran dentist friend who is looking at ways to involve a US health group in some work in our region asked me to take photos of the center.

It’s quite a beautiful center with eight rooms. The construction was funded by the local municipal government – not the national heath system.

There are some chairs, desks, examination tables. There are several employees – only one of them paid by the national health system. The others are paid by the local government.

But there is no medicine. Not even acetaminophen!

This is not unusual.

A few days ago I spoke with the local mayor, who lives in Plan Grande. He asked me when I was going to the US. He would like to find sources of assistance for the health center. There is no assigned doctor for the three health centers in the municipality, though there is a young doctor doing his year of social service.

Despite millions being poured into Honduras by the US government and other groups, the poor do not have decent access to health care.  The military and the police get the funds, but what about the poor?

I recently noted that the US is sending 250 Marines to the US base in Palmerola, Honduras. (The US claims, though, that the base is Honduran and call it Soto Cano.) They are supposedly for hurricane relief – but are also meant to support the military here in counter-narcotics efforts.  I have doubts about their presence - in an already highly-militarized country.

A final note: The center I visited is where the US military brigade came for two days in March.

They had lots of medicine. See my blog entry here.

But now: not even bandaids!