Information for Information for Prospective VolunteersProspective Volunteers

HondurasHondurasPopulation 7.9million

0-14 years: 38.1%0-14 years: 38.1% 15-64 years: 58.3%15-64 years: 58.3% 65 years and over: 3.6%65 years and over: 3.6% Median age: 20.3 yearsMedian age: 20.3 years 59% of population at or 59% of population at or

below poverty linebelow poverty line Infant mortality: 21.04 Infant mortality: 21.04

deaths/1,000 live births deaths/1,000 live births 6 physicians & 2 dentists 6 physicians & 2 dentists

per 10,000 population (even per 10,000 population (even less in rural areas)less in rural areas)

NicaraguaNicaragua

Population 6 million 0-14 years: 33.8% 15-64 years: 62.9% 65 years and over: 3.3% Median age: 22.5 48% of population at or 48% of population at or below below poverty linepoverty line• Infant mortality: 24.16 deaths/1,000 live births • 4 physicians & 1 dentist per 10,000 population (even less in rural areas)

Challenges for VolunteersChallenges for Volunteers

Physical, emotional & intellectual demandsPhysical, emotional & intellectual demands

Need to remain flexible & Need to remain flexible &

non-judgmentalnon-judgmental

Avoid the “ugly American” labelAvoid the “ugly American” label

Sensitivity to cultural differencesSensitivity to cultural differences

Cultural DifferencesCultural Differences

Different concept of personal spaceDifferent concept of personal space

(people tend to stand closer than (people tend to stand closer than Americans are used to)Americans are used to)

Do not assume “sameness”Do not assume “sameness” ““Familiar” behavior can have Familiar” behavior can have

different meaningsdifferent meanings Different attitude towards problemsDifferent attitude towards problems

Diet, Health & AttitudeDiet, Health & Attitude

Poor food productivity & low incomes lead to a very low standard of living in rural areas. Typical diet consists of tortillas, beans (main source of protein), rice, cassava, plantains & coffee, with only occasional supplements of meat or fish.

Although pigs & chickens are widely raised, meat is infrequent in rural diets, as are green vegetables.

Widespread malnutrition complicates the population’s fragile health.

AttitudesAttitudes

Most of the population do not relate their health Most of the population do not relate their health problems to their real causes (malnutrition, problems to their real causes (malnutrition, environmental hazards, etc.)environmental hazards, etc.)

Much of the population on a continuously Much of the population on a continuously inadequate diet, not dramatic shortage of foodinadequate diet, not dramatic shortage of food

People fail to relate disease, illness, low People fail to relate disease, illness, low productivity to poor diet & lack of sanitationproductivity to poor diet & lack of sanitation

Because these problems always existed, Because these problems always existed, they tend to be accepted as normal.they tend to be accepted as normal.

Other Cultural DifferencesOther Cultural Differences Primacy of tight, intimate emotional relationships with Primacy of tight, intimate emotional relationships with

family and close friends.family and close friends. Sense of life’s unpredictability and role of destino (fate). Sense of life’s unpredictability and role of destino (fate). Tendency toward hierarchy and stratification of social Tendency toward hierarchy and stratification of social

structure.structure. Importance attributed to physical looks, clothes, style, Importance attributed to physical looks, clothes, style,

dignity, social graces as way of indicating one’s place in dignity, social graces as way of indicating one’s place in society. society.

Less attention given to punctuality and “efficient and Less attention given to punctuality and “efficient and productive” time use than to immersing oneself into life productive” time use than to immersing oneself into life itself. itself.

Arrival – Arrival – from the airport in Honduras, we go to the from the airport in Honduras, we go to the

warehouse to get supplies & pack the truckwarehouse to get supplies & pack the truck

The First Night at the HotelThe First Night at the Hotel

Luxury accommodations you won’t Luxury accommodations you won’t likely see again until week’s end.likely see again until week’s end.

Sometimes we stay overnight in a hotel en-route to our work site.

Off to the work siteOff to the work site

Arrival & Set-upArrival & Set-up

Work SitesWork SitesOften a school or ChurchOften a school or Church

Long lines of patients usually greet usLong lines of patients usually greet us

Living & Sleeping Conditions VaryLiving & Sleeping Conditions Vary

Normally conditions are pretty basic

On rare occasions conditions are On rare occasions conditions are downright luxuriousdownright luxurious

Bathing is sometimes an adventureBathing is sometimes an adventure

Just keep your eyes & mouth shut

Chow TimeChow Time

Villagers live with their farm animalsVillagers live with their farm animalsEar plugs are helpful for sleepingEar plugs are helpful for sleeping

Roosters don’t crow at dawn; they start much Roosters don’t crow at dawn; they start much earlierearlier

Scenes from Central AmericaScenes from Central America

Medical ClinicMedical Clinic

Common Medical ConditionsCommon Medical Conditions

Gastrointestinal illnessGastrointestinal illness Parasitic infectionsParasitic infections Urinary tract infectionsUrinary tract infections Respiratory infections and asthmaRespiratory infections and asthma Work related injuriesWork related injuries Skin conditionsSkin conditions Tropical diseasesTropical diseases

CausesCauses

MalnutritionMalnutrition Impure waterImpure water Poor personal hygienePoor personal hygiene Inadequate housingInadequate housing Poor sewage disposalPoor sewage disposal Environmental hazardsEnvironmental hazards

Dental ClinicDental Clinic

Dental DiseaseDental Disease

High caries rateHigh caries rate Early childhood caries Early childhood caries Missing teeth, residual rootsMissing teeth, residual roots Minimal oral hygieneMinimal oral hygiene Rarely complaints of pain, despite Rarely complaints of pain, despite

infectioninfection Diet high in sugar and carbohydratesDiet high in sugar and carbohydrates

Eye ClinicEye Clinic

Eye ClinicEye Clinic

CataractsCataracts Corneal ExposureCorneal Exposure PtergiaPtergia HyperopiaHyperopia Refraction Refraction Dispensing glassesDispensing glasses

PharmacyPharmacy

Pharmacy ChallengesPharmacy Challenges

Set up Pharmacy in less than 3 hoursSet up Pharmacy in less than 3 hours Instruct illiterate patientsInstruct illiterate patients Adapt prescriptions to a limited Adapt prescriptions to a limited

formularyformulary Different names for familiar drugsDifferent names for familiar drugs High volume of patientsHigh volume of patients

EducationEducation We try to incorporate patient & We try to incorporate patient &

schoolchildren education into our schoolchildren education into our brigadesbrigades

Often the final day is free for Often the final day is free for sightseeing & shoppingsightseeing & shopping

The Mayan ruins at Copan

Despite All The Hardships, It’s Despite All The Hardships, It’s Worth ItWorth It

MEDICOMEDICO2955 Dawn Drive, Suite D2955 Dawn Drive, Suite DGeorgetown, Texas 78628Georgetown, Texas 78628Telephone: (512) 930-1893Telephone: (512) 930-1893

Fax: (512) 869-7500 Fax: (512) 869-7500

www.medico.orgwww.medico.org