Having never received any form of attention from a person knowledgeable in the medical field, their first reaction was to cry with joy.
Even though they had outfitted their town with electricity and running water about six months earlier in order to draw American medical personnel, many citizens of Chaguitillos, in the Central American country of Honduras, were still overcome with emotion when the foreigners arrived in their remote community.
Houston resident Amanda Cook was among the band of 25 Americans who traveled to Honduras this summer as part of a two-week medical mission trip sponsored by the University of Missouri – Kansas City (UMKC) school of health professions. The group – consisting of 21 students, four faculty and four translators – worked with patients at clinics and hospitals in and around three cities: Comoyagua, San Isidro and San Pedro Sula.
“It’s extremely different there,” Cook said. “The public hospitals are government-funded and it was not unusual to see somebody waiting for a day to two days in the ER and then nine days to get a room. If they don’t die first, they get a room.”
Mission participants were divided up so that two pharmacy students worked with one nurse. Because of the volume of patients to tend to and the shortness of time, things like official qualifications often took a back seat to the task at hand.
“We saw between 150 and 300 patients a day,” Cook said. “And they didn’t care what letters were after your name as long as you were bandaging them or assessing them. They were just extremely grateful to have someone helping them.”
Equipped with the limited supply of medication that they were allowed to check in at the airport, mission group members sometimes found themselves in the difficult position of having to prioritize the distribution of medication.
“Deciding who was the most deserving was one of the hardest things we did,” Cook said. “We always had to consider how bad each case was and how many meds we had left. Like if someone had high blood pressure, we had to think ‘is his the highest in the waiting room? Or are we going to need this medication even more later?'”
To Hondurans living in poverty, a hospital isn’t necessarily a place you easily go to, receive treatment, and go home. It can take two days to reach one, sometimes requiring a long walk, followed by a long bus trip, followed by another long walk.
And when you get there, you’re greeted by overcrowded conditions and that nine-day wait for treatment.
“You couldn’t walk through the halls because there were so many sick people,” Cook said. “And to them, you go to a hospital to die. It really makes you think about our own health care system.”
Medical assistance or attention is rare for many Hondurans who live primitive lives in mountain regions, often in sight of more affluent conditions in the valleys below.
“And the people who live in the mountains never come down,” Cook said, “and vice-versa.”
The mission group experienced working in both public and private hospitals in the San Pedro Sula area (in the northern part of the country, not far from the border with Guatemala). Cook said the public facilities might charge patients only about $15 a day for their services.
“But you get what you pay for,” she said. “And the private hospitals are mainly for wealthy people or drug lords.”
Observing strange and unusual cases was not uncommon for mission members, even during the relatively short time they were in Honduras. Cook recalls having a man show up in a clinic with a bandaged head. He had sustained a gunshot wound 25 years earlier that had never been treated and had turned cancerous.
“And here we are, a bunch of pharmacy students and a few nurse practitioners,” Cook said. “Our biggest concern for him was that nobody had been feeding him. He had no family and he could barely eat because his mouth was so small.”
Sometimes the mission group’s arrival was expected, other times its appearance was a surprise. The emotional scene in Chaguitillos (near Comoyagua, in the western portion of the country) was one such occasion.
“We had a change of plans, so we set up a clinic in an old Spanish neighborhood that hadn’t had health care in 15 years,” Cook said. “That was totally on the fly; it was like ‘OK, grab your tarps and your bags of meds and we’re going to this place where nobody’s been.’
“People were in awe and just cried when we pulled up. But drawing in American medical groups was their main reason for getting water and electricity – they knew that otherwise nobody would come to give them services, because they wouldn’t want to live without water or electricity.”
The irony of that situation didn’t escape Cook’s notice.
“I thought ‘how sad is that?'” she said. “These people live without it every day, but they want to do this so that we will come in – so that Americans will come and help them.”
A typical day for the mission group started with a meal in tiny store prepared by a local woman hired to feed the foreign visitors.
“All 25 of us would try to cram in there,” Cook said, “and keep in mind we’re all taller and bigger than any of the local people. And the lady tries to estimate how much to cook, because she doesn’t generally cook for large groups.”
From there, it was about going to a hospital or clinic and spending the day assessing peoples’ needs and doing whatever possible to help.
“And it was mostly school desks, tents and tarps,” Cook said.
A Houston native who recently finished her course work at UMKC’s satellite campus in Columbia, Cook is a former Houston High School teacher whose husband, Bennie Cook, is a deputy with the Texas County Sheriff’s Department.
She said her goal in going on the mission trip was to get in some real-life preparation that would allow her to be more effective in a natural disaster situation.
“I told my husband that there’s no worse feeling than to have the training but not know how to implement it,” Cook said. “And it was awesome in that I had already been approved to go on this trip, and then Joplin happened. Then I told my husband ‘this is exactly what I mean.'”
The mission’s overall goals included giving students a chance to learn assessment techniques, work with other people in the health care field, and learn what it’s like to treat a culturally sensitive population.
“We have different patients with different needs,” Cook said, “and we have to individualize our care based on who the patient is, not how we want to treat them.”
To complete her schooling, Cook will intern at various locations in the area, and she’s currently doing just that at Forbes Pharmacy in Houston. After graduation, she’ll be taking a position at Texas County Memorial Hospital in May or June of next year.
Cook won’t be expecting long breaks between assignments; she returned from Honduras on Aug. 1 and started at Forbes the following day.
“And that’s how it’s going to work again this month,” she said. “I’ll finish here on the 31st and I start at University Hospitals in Columbia on Sept. 1st.”
But regardless of tight scheduling, the mission to Honduras had a profound effect on Cook, shaping her future and giving her a new perspective.
“That was an amazing experience,” she said. “It’s something I plan to do again, and I hope I get the opportunity to do it again. I would love to go back to Honduras, but knowing there might be other places with higher need, any opportunity like that would be great.
“Need is need.”