Doctor's Review: Medicine on the Move

May 29, 2017
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MEDICO to Honduras

Last March, my wife Lola and I travelled to Honduras with MEDICO ( www.medico.org ), a secular, volunteer organization based in Texas which provides medical, eye and dental care to rural areas of the country. Our group of 25 volunteers was based at a coffee plantation in the mountains near the Guatemalan border.

We were excited to be so close to the Maya archeological site of Copán, often called the Athens of the Americas due to the beauty of its architecture, intricate carvings and extensive stone hieroglyphics. But we wouldn't get a chance to see this UNESCO World Heritage Site until the end of our weeklong stay.

The first leg of our journey from the airport in San Pedro Sula took us along a two-lane highway that turned into a narrow dirt track after the town of Copán Ruinas. Snaking along a tributary of the Copán River, the road came to a dead end at the Hacienda Rosalila, a 75-year-old coffee plantation run by Teresa de Castejón and her daughters. Across the valley, all we could see was verdant jungle rising to the mountain peaks. Coffee bushes were being shade grown beneath the canopy of trees. The village of El Cisne, adjacent to the hacienda, was home to most of the plantation's 1000 workers and their families.

At the hacienda, host Doûa Teresa opened her charming home to us. The grounds had lush vegetation, tropical flowers and four species of hummingbird. Its amenities were so much greater than those of MEDICO's usual accommodations that it was soon nicknamed Club MEDICO.


Standing Room Only
Doûa Teresa had organized the schedule of clinic visitation for each surrounding district. Many patients had walked up to four hours along steep mountain paths. Crowds gathered around the gate waiting patiently to be triaged. Adults and children wore impeccably clean clothes but were often barefoot. The school porch became a busy waiting room with Maya people of all ages chatting sociably. The entire process had a festive air. A few enterprising families even set up tables to sell drinks, tortillas, chicken or ice cream.

The medical clinic was set up in two of the three rooms of the small local school. In this limited space, five doctors, six nurses, paramedics and translators worked. I was paired with Ray Estrada, a firefighter, EMT and RN. Fluent in Spanish, he also performed translation duties. My wife Lola rotated through the medical, dental and eye clinics, assisting with procedures and snapping photographs of the staff working with patients. In the eye clinic, exams were done by optometrist Lynn Purcell, who was able give patients donated eyeglasses.

The clinic was crowded with people. Many of our patients had never been examined by a physician before. I sometimes paused to watch and listen while others were taking histories, examining entire families or giving and explaining treatments. The most common illnesses treated were external and internal parasites, skin and respiratory infections, trauma and asthma.

In one case, a father stated that his eight-year-old son, although currently healthy, had experienced an asthma attack six months ago. He asked if we had anything for his next episode. Upon examination, the child had severe wheezes. To his pleasant surprise, they cleared with one inhalation. We were able to supply him with oral medication and inhalers.

We spent seven days practising bare-bones medicine in this chaotic environment and became good friends with many in our group. Our medical leader, Ken Carlson, had done his residency at Toronto's Hospital for Sick Children and now practises in Dallas. Also with us was Dr Salvador Paredes, a pediatrician from San Pedro Sula who frequently accompanies the MEDICO groups. We found him very knowledgeable about his country and its medical needs and, naturally, he's the primary contact for MEDICO in the area. His daughter, Paola Paredes, a pediatric dentist, was also on the trip.

In the evenings, we were able to explore the village, the surrounding hills and the plantation. Dinner and breakfast were the only times our entire group was together and the air filled with an animated mixture of English and Spanish. One evening, we piled into the back of two pickup trucks, Honduran-style, for a trip to the local hot springs in the village of Agua Caliente. We had to cross a small suspension footbridge to reach the springs, whose waters were piped into two pools in which we soaked away the day's aches and pains.


Ruining the Trip
It was only after our week's work was over, as we were heading back to San Pedro Sula to catch our flight, that we finally had the chance to visit ruins of Copán. The site, small by Maya standards, is easy to explore. Lola had brought site maps and made extensive notes from her studies of the area, providing details of its history as we stopped at each marvel.

The Great Plaza is located north of the Acropolis, an elevated pyramid complex with royal residences, council houses and sacred temples. Entering the plaza, elaborate altars and 11 stelae exquisitely carved in andesite greeted us. Each stela honours a different ruler with a life-size carving of the regent dressed with elaborate jade jewellery, jaguar-skin robes and headdresses made from the plumage of the revered macaw and quetzal birds. The accompanying hieroglyphics recounted his life and successes at war.

Copán is famous for its magnificent Hieroglyphic Stairway, which dates back to the late eighth century. The front of each of the 2200 stair blocks is carved with hieroglyphics, making it the longest text in the Americas. Statues of six rulers ascend along the centre of the 63 steps. Adjacent to the stairway is one of the famous Maya ball courts -- a symbolic model of their tripartite universe in which the playing field represents the earthly plane. This court, the largest in the southern Maya lowlands, was initially constructed in the fourth century but modified by subsequent rulers. New structures were frequently built over existing pyramids, a practical building technique that also honoured ancestors.

At Copán, tunnelling has exposed two of these buried structures. Visitors can enter the tunnels to see Rosalila, a spectacular sixth-century temple with intricate carvings once painted a brilliant red. Considered sacred, Rosalila was preserved intact by a conquering ruler before it was interred within subsequent pyramids.

One beautiful square altar, Altar Q, has only recently been deciphered. On each side, four rulers have been carved in profile and the scepter of royalty is shown passing from the first ruler, Kinich Yax K'uk Mo, to the 16th and last-known ruler, Yax Pac. During his rule in the late eighth century, escalating problems of overpopulation, environmental degradation and inadequate resources pushed Copán into decline. Ultimately, centralized rule collapsed but the Maya continued to inhabit nearby residential zones, just as they do today.

As we drove away to the MEDICO warehouse in San Pedro Sula to unload supplies, we were already reminiscing about the trip with our new friends. All too soon we were sharing our last meal as a team on the poolside terrace of the Hotel Real InterContinental before catching our flights home.

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