A visit to the Hospital…

Last Friday, we were invited to go with the nursing students in Guiamaca to tour the largest hospital in Tegucigalpa, Hospital Escuela. I’m not 100% sure, but I think this hospital is probably the largest public hospital in the country. We knew going in, that this would be nothing like any hospital we’d ever been in before, and I guess that’s something we could be thankful for. But for most people here, this hospital is their only option for healthcare. If people have the money to pay for their care, they pay, but if someone has no money, they receive treatment anyway. We started our tour in the pediatric emergency room, which was basically a room filled with somewhere around 75 mothers and children waiting to sign in and be seen. The patients spill over into the hallways, where they just sit on their beds with family standing nearby. The adult emergency room was worse though with more seriously injured patients crowding the walkways or sitting on chairs in the hallway. This is also the hospital that receives most of the victims of gang violence in the area- gunshot wounds, stabbings, etc. From there, we toured a number of the inpatient floors in the hospital, which all looked pretty much the same- rundown, leaking ceilings and full of people. On the pediatric floors there were 6-8 beds in each room, but they were decently sized and even included a TV for the kids. The adult floor we walked through had about 5 people in each room, but these rooms were a lot smaller- probably the size of a normal hospital room we’re used to. This particular day, there were 40 patients on this floor and 3 nurses working this shift, 2 for evenings and 1 overnight. The shared bathroom for this floor is down the hall with 2 stalls. The nurses were all very welcoming to us though as we took up space on their cramped floor and their time, but they took us room to room telling us the diagnosis of each patient so we could get an idea of the wide variety of things they see there. As we walked into the first room, we were surprised to find only one patient, but the nurse explained that this woman had HIV and that was why she needed to be in a room by herself. That caught us off guard a bit, mostly because she was openly discussing this woman’s HIV status and health problems with the 8 of us, a random tour group, but I guess we already knew that patient confidentiality doesn’t exactly exist here. Secondly, just the fact that they gave her her own room in an incredibly busy floor based on her HIV status illustrates a lot of the unfortunately common misconceptions and lack of education on HIV and AIDS in this country. The rest of the rooms on the floor were full of patients with common problems, as our ability to translate their diagnoses from Spanish to English was tested by the nurses. We saw a woman on an interesting makeshift ventilator system, and found out that the patients on the floor have to pay upfront if they want any medications such as painkillers. We had heard before that if you want to eat while you’re in the hospital your family has to bring food in for you, but it appears that at least some of the floors have a sort of food service now. It was obviously an interesting morning spent learning about the struggles of providing health care in Honduras, where resources are so limited. I’m thankful thought that we had the opportunity to see how and where the people we work with receive their medical care. They definitely do what they can with what they have, giving us a good lesson in resourcefulness, but I can’t imagine how challenging it must be to work there. So for that reason, don’t worry… I didn’t apply for a job there, even though my chances of getting one would probably be high considering they asked if we were sticking around to help out after our tour. And secondly, in case anyone was curious/worried, this is not the hospital we would go to if we needed medical care for any reason. There happen to be nice, private hospitals in Tegucigalpa as well, which provide care to those select few with insurance and/or money.