Well-Being For All

Health Care Challenge for Hondurans (or part 5)

Health Care Challenge Rural Reconstruction Program, La Buena Fe, Zacapa, Honduras : August 20, 2006

Everyone needs good health and access to quality health care to help sustain that good health. That point is not in question. What is in question, is who decides what is the standard of “quality health care” and who pays for it?

The PRR Program, a longtime partner in Honduras, has a health component. The Program has operated a clinic and provided emergency and maternal health care since its inception. A dental technician was also part of the clinic to do fillings, pull bad teeth and make new false teeth. The dental technicians have now moved on and opened their own private clinics. They operate at a rate that the local people can afford.

This has not happened with the health clinic. Private clinics are now operating within a half hour by bus from the PRR clinic which is by no means easy to access from remote villages without a four wheel drive truck which most communities do not have. In addition, the old standards of health care seem to no longer be as acceptable and PRR is under increased pressure to provide a doctor.

The current Honduran Government policy is not to place a doctor in any clinic building that is not community owned. The PRR clinic is on private land and therefore is not eligible for government help. If the doctor worked part time, the salary would more than double the health care cost of the two nurse practitioners. Doctors also need additional diagnostic tools like x-ray, ultrasound and a larger pharmacy with a larger stock of expensive drugs. Who would then pay for the drugs if the poor cannot afford them? All of these things are costly and it seems irresponsible to place a doctor there with no additional resources. Who would hire a carpenter but not provide wood or nails to work?

Governments in North America struggle with the high cost of medical care. The US model of some public and many private health care clinics and insurance is the model Honduras is following, but for the very poor, there simply is no access. There are too few Government hospitals and the private ones are just too costly.

The PRR Program now favours more public health education to try to reduce known problems in the villages, and thus mitigate unnecessary health costs for the poor. PRR would continue with limited clinic services, and refer serious cases to larger centers. It may be better stewardship to take serious cases to hospitals and even pay the bill for the poorest people than to provide treatment services.

Even something one might expect to be fairly simple compared to serious development issues, sometimes is not simple at all.

Terry Fielder, From Honduras

posted by World Accord Staff @ 12:39 PM