AHMEN Medical Missions in Honduras: AHMEN/CHIMES Medical Mission to Honduras: Part 2

Moskito Indians at riverside

Second in a series of entries dealing with the recent AHMEN/CHIMES Medical Mission to La Moskitia, Gracias a Dios, Honduras. April 25-May 7, 2011

Day 4. The new truck is on the way to Pueblo Nuevo, and we are all ready for our first medical clinic. We will travel up the Rio Tinto Negro about two hours to the village of Limonales. The river is as wide as 250 yards in places and winding slowly through coastal jungle where the riverbank is lined with banana trees and dotted with Miskito indian homes. The water is low right now, and the 40 foot canoe occasionally scrapes bottom. Miskito women stand waist deep washing clothes as children swim near them. Many children wave back as the strangers pass by their traditional thatched platform homes. There is some traffic on the river today. Small dugout canoes loaded with plantains, sand or people pass by. Their canoes sit so deeply in the water that you wonder why any onboard movement doesn't swamp it. In some, people stand to pole the boats, a testimonial to their balance and experience. There are large critters in this river. I've seen porpoises, I've been told there are sharks as well as the usual crocodiles (caiman). Water birds fly away as we approach and vultures make their lazy rounds. Graceful frigate birds glide forever with no apparent effort and the scolding bright yellow King birds are seen frequently.

Limonales clinic. Brent Brady, Tom Arnold and Delmer Montoya

We arrive in Limonales and set up our clinic in the school building. Unannounced, it takes about an hour for word to spread that there is a medical brigade in the village. It takes that long to set up the pharmacy and to set up examination areas for the doctors. Each patient is registered and their vital signs taken. They may also have a screening blood sugar done. We have four physicians with us so patients are seen quickly. Prescriptions are filled from our well stocked pharmacy and careful patient instructions are given in Spanish by Doris and Eduardo. Mario and Stephanie maintain crowd control. Antonio does a few massages. We see well over 100 people in a couple of hours.

Wes Wallace speaks with a patient in Limonales

Most patients are treated for parasites and request vitamins. There are a few rather sick patients including one child born on the day of our first AHMEN clinic in Limonales. The child has hydrocephalus and many other problem. Severely disabled, he now has started to have seizures and has a fever. We do what we can for this pitiful situation. We eat lunch on the fly and plan to be back in the boat by 3:30. Travel on the river is not safe at night. Limonales has changed is the past six months. There is some public building construction and there is even a pickup truck in town. How they got it there would be an interesting story in itself. With increased prosperity comes the plague of civilization, there is plastic trash all over. There are satellite dishes attached to some of the tiny homes. An unmarked Cobra helicopter flies low and fast along the river. This is my fourth time to Limonales and I've seen many changes in two years, not all for the better. Six months ago, there was a Cuban doctor stationed there. Cuts by Cuba has pulled most of the physician staffing from Honduras. There is a public health nurse there, but she has minimal supplies. The nearest doctor is in Palacios two hours away. Life goes on.

We travel back to Palacios to find that the three other members of our team are back. At full strength, we will set out for Las Marias early the next morning. We will travel as light as possible, taking only what is necessary in addition to our medications. The Rio Plátano is low and there has been little rain. We eat dinner at the hotel and ready for the morning. We are all tired.

Canal from Ibans lagoon to the Rio Plátano

Day 5: The next morning we are late setting off in our two large canoes. Sometimes I wonder why we even bother to set a departure time. One on the canoes was 90 minutes late and then the driver needed to stop for 30 minutes along the way..... whatever! Finally, we reached and traversed Ibans lagoon, and entered the canal that accesses the Rio Plátano. The canal is through a dense coastal mangrove swamp looking like a scene out of The African Queen. We finally reach the the river and we turn upstream. Dense jungle line the banks. About 150 feet wide, there are huge trees along the way and many even larger logs lay in the river from previous floods. The small engine hums and causes a little breeze. We lather ourselves with sunblock and watch the sky for birds, and the banks for crocs. The river goes on and on.

Moskito family home for eleven children

We stop on a sandy bank for a pit stop. There is a modest Miskito home there and we spend a brief time with them. We buy some roasted corn and meet the family. The are eleven children and the parents. The mother is 33 years old. Their home consists of raised platform of split bamboo covered by a thatched roof. No walls. The eldest child is about 10 or 12 years old. The children are polite but shy. They all like seeing themselves on a camera display. There was not an X-box within a hundred miles.

Further upstream, the river becomes narrower and shallower. Exo, the young man riding the bow, directs the pilot away from hidden logs and rocks.... most of the time. The frequents heavy rains caused great trees to choke the river and in

Pico de Damas at sunset

places. We must wind our way through a maze of logs and stumps. Occasionally we run aground and we must exit the boat to pull and push the boat into to deeper water.. The footing is uneven and we laugh as each of us takes a turn getting wetter than we wanted to. The shallow spots became more frequent and the current more strong. Dragging the boat upriver became extremely difficult and dangerous. At one point, one of the team became so tired that they were unable to stand against the current and was a real danger of being swept away. It was rapidly getting dark and we could the silhouette of Pico de Damas mountain in the distance. This is where we were going. The driver kept telling us we were almost there for what seemed like an eternity. Every time we ran into another shoal we would have to exit the boat and pull and push it across the rocks hoping not to fall and be seriously injured. At hard dusk, we finally arrived in Las Marias with arms and legs intact.

Hotel at Las Marias

Las Marias is the last village on the river that can be accessed by motorized boat. Beyond here, the river can only be traveled in a pitante poled by indian boatmen. Las Marias is a Miskito village. Beyond here, the reclusive Pech indians live mostly as they have done for generation. This is true rain forest. Huge unfamiliar trees laden with orchids and bromeliads are everywhere. Birds squawk their vespers in a thousand voices. The hotel is ready for us with its five rooms. There is another lodge a brief walk down a path where some of us will sleep. There is a generator for a couple of lightbulbs, but candles are the only light in the rooms. Each bed had a mosquito net and some even have no holes. The building sits on stilts, and pigs, chickens and even larger farm animal run beneath it. A tipico dinner was served and we all went to bed exhausted. The morning will bring the first of two clinic days.

Pat and Sug doing what nurses do best.

Day 6: Breakfast of eggs, frijoles, fritas and strong Honduran coffee greets us as we plan for the day. We carry our supplies to the local school and set up. Miskito indians are handsome people, and the children are especially so. Freshly scrubbed and on their best behavior, the kids were all cheerful and brave, even when they received an injection. A frisbee gave hours of fun near the school and an air pump brought the local pelota de futbal to life. We treated almost 170 people on the first day of clinic. There were a few cases of malaria, and lots of parasites. We also treated diarrhea and skin infection and the usual gripe. There was not as much hypertension and diabetes as among the Garifuna. On the second day a one month old child was brought to see us, febrile and extremely dehydrated. The child needed IV fluids if it was to survive. An external jugular vein line was placed by Wes Wallace and the child was quickly rehydrated. We suspected an abscessed neck because of the local swelling. Large doses of antibiotics were given and plans were made to see the child again in the morning. The mother was carefully taught what needed to be done to keep the child alive. We hoped she understood. There is a public health nurse in Las Marias. We spoke with her about the sick baby and made arrangements to continue therapy. We may never know what becomes of this child. Moskito families do not name their children at birth, a tradition born out of the high infant mortality in the area. On the second clinic days we saw a few Pech indians. More oriental in appearance with straighter hair and higher cheek bones than the Miskito, they live far away from the village in the forest. They are shy and rarely come to town except at night. In fact, we innocently asked a local if they were Moskito or Pech before we knew, and they all started laughing about our ignorance Apparently there are social strata even among the residents of the rain forest. There are much less that 2000 Pech left as their identity slips into history.

Dr. Ben Coplan and Brent Brady await their next patient.
Photo by T. Arnold

We had never held a two day clinic in Las Marias. This village is so remote that no doctors ever come here. We were not sure how many patients we would see. On the second day we saw about 50 including our sickest patient. We had time to rest and explore the area after we closed.

Las Marias is a village out of the past. There are no cars or motorcycles. There are a few generators but the cost of fuel here precludes all but special use. People grow what they eat. We were served fresh fish and a little pork, even some deer killed in the forest.

Although off the beaten track, there were other guests at the hotel. Two young men from Germany and a young woman from England stopped here to climb Pico de Damas. They had been traveling for months through Central America. Their destinations were Nicaragua and Brazil. Oh, to be that young and free again!

Day 8: The sick child from the day before was brought to the hotel looking as good as we hoped for. Another injection and careful instructions to the mother and town nurse were given again. The local pastor prayed for the child and we all wondered about its future. We climbed back into the canoes for the trip downriver to Raista located on the shore of Ibans lagoon. It rained last night heavily and we were hoping there is more water in the river. The current will speed our way. The trip was indeed faster and there was a bit more water, but we still had to drag the boat in a few places, but it was easier. Next stop: Raista.