Unnatural Disasters

Article excerpt

Abstract:

On October 27, 1998, Hurricane Mitch slammed into the Caribbean coast of Central America. UN officials have classified Hitch as the worst natural disaster to hit the region this century. In Honduras alone, 14,000 lives, billions of dollars worth of crops, and 45 years of infrastructural development perished in flashfloods and landslides. Many Hondurans, whose already scarce property and employment were devastated by the hurricane, are slowly working to rebuild housing and businesses as they always have, with only a short-term focus. But a growing contingent is breaking away from the traditional mentality toward public reconstruction, especially in the field of health care. This group sees not only a destroyed country, but also a newfound opportunity to rebuild a sustainable, modern medical system. These reformers recognize that Honduras's fundamental well-being rests on crafting an improved public health system with a long-term focus.

Text:

On October 27, 1998, Hurricane Hitch slammed into the Caribbean coast of Central America. UN officials have classified Mitch as the worst natural disaster to hit the region this century. In Honduras alone, over 14,000 lives, billions of dollars worth of crops, and 45 years of infrastructural development perished in flashfloods and landslides. "Those figures, however, are not capable of appraising the pain, the fear, and the insecurity people have suffered and are still experiencing," reports Mary de Flores, the First Lady of Honduras. Many Hondurans, whose already scarce property and employment were devastated by the hurricane, are slowly working to rebuild housing and businesses as they always have, with only a short-term focus. But a growing contingent is breaking away from the traditional mentality toward public reconstruction, especially in the field of health care. This group sees not only a destroyed country but also a newfound opportunity to rebuild a sustainable, modern medical system. These reformers recognize that Honduras's fundamental well-being rests on crafting an improved public health system with a long term focus.

Systemic Infections

For the past several decades, the public health system in Honduras has focused on treating communicable diseases as well as responding to natural disasters through heavy reliance on international aid. Since the late 1970s, low-income tropical countries including Honduras have waged a serious war against communicable diseases. The results are now becoming apparent: communicable diseases, even the most historically virulent killers-malaria, dengue, and tuberculosis-are receding, and Honduras now boasts 98 percent nationwide participation in its vaccination program. Poor health in the wake of Hurricane Mitch did not result in the anticipated outbreaks of malaria and tuberculosis, dispelling the conventional wisdom that these diseases are still catastrophic afflictions in Honduras.

The Ministry of Public Health, which both regulates and delivers national healthcare through a network of 28 hospitals, 214 physician-staffed health centers, 727 rural health centers, and nine maternal and child clinics, is the central figure in the Honduran health network. But the Ministry is in fact only one part of a multi-faceted system; many foreign non-governmental organizations (NGOs) complement the work of the Ministry by providing necessary specialized medical services. These groups organize vaccination drives for children and pets in rural villages, deliver necessary medicine and supplies, monitor nutrition, conduct follow-up checkups, and coordinate transportation to hospitals. Much of the innovative input comes through NGOs that draw on medical standards from developed countries but are willing to experiment with new approaches in Honduras.

Recently, however, the Honduran health system has been beset by instability. The frequent turnover of the Ministry of Health's management, which corresponds to the quadrennial election of a new national president, has disrupted continuity among programs and has barred attempts at large-scale modernization. …