Special Guest Blog Post from Nadia Masroor: February GH2DP Outreach Trip to Yoro, Honduras

This is a special guest blog post by Nadia Masroor, who has joined us on the last few health outreach trips to Yoro, Honduras, and who recently returned from Honduras: 

Our February trip to Olanchito and La Hicaca provided some excellent feedback on several ongoing projects. On Thursday February 12^th, Dr. Bearman and I had the wonderful opportunity to meet with Padre Pedro and the rest of the Catholic priests in Olanchito for lunch.

Afterwards, Dr. Bearman, Padre Pedro, and I met with the Pico Bonito Foundation to discuss their progress on current projects. Pico Bonito has successfully installed chlorination systems in La Hicaca, Chorro Viento, and Puerto Rico. Those living in these three villages are encouraged to use the chlorinated water cisterns for their water supply. In order to determine the efficacy of chlorination, the 2015 brigade team will plate and incubate chlorinated water to assess microbiological growth. As for those who do not have access to the cisterns, an estimated 90-100 filters will need to be distributed in June 2015.

Hike to Chorro Viento

The Pico Bonito Foundation has recently installed new cook stoves in many of the homes in LaHicaca. According to the foundation, each cook stove costs about $100. We plan to continue this project by funding Pico Bonito to install another 15-20 cook stoves this year. Padre Pedro and Rosa, who is the nurse providing care to the people of La Hicaca and surrounding villages, will determine which impoverished homes are most in need of cook stoves. In conjunction with the cook stoves, the Pico Bonito foundation has also agreed to install new latrines for the people in Sector La Hicaca. Approximately 15-20 latrines, which cost $100 each, are projected to be built throughout the village this year. Lastly, in order to replace the deteriorated school latrines, we have requested 4 new latrines to be constructed as well, which have been estimated to cost $800-$1000. To say the least, our meeting with the Pico Bonito Foundation has enlightened us on the plethora of projects we can initiate in order to improve living conditions in La Hicaca and surrounding villages.

Later that day we met with Dr. Alma Nunez from the Ministry of Health to discuss the June 2015 brigade. Historically, La Hicaca has been the clinic site for 3 days and Lomitas has been the clinic site for 2 days. This year, however, Padre has advised spending 2.5 days in La Hicaca and 2.5 days in Lomitas. By increasing clinic time in Lomitas, Dr. Nunez and Padre hope that the brigade will be able to extend its care to more people. The total number of brigade clinic sessions will remain the same. In addition, Padre Pedro will work with the Ministry of Health to provide dental services for 3 days, covering both La Hicaca and Lomitas.

Based on Brock University’s findings from the June 2014 brigade, the majority of the population suffers from Trichura, which cannot be effectively treated with albendazole alone. Thus during this year’s brigade we will be distributing oxantal pamoate in addition to the albendazole to provide enhanced Trichura coverage. Padre Pedro has taken on the task to inquire and purchase both the albendazole and the oxantal pamoate.

Cistern in Chorro Viento

Dr. Nunez has proposed aggressively promoting the brigade via Radio Catolica broadcast in order to increase awareness and participation. Therefore, Padre Pedro will collaborate with Radio Catolica in order to provide the brigade dates and details about the services offered. We hope to see an increase in the number of people who attend the brigade in June.

On Friday February 13^th, we traveled to La Hicaca so that could meet with Rosa in el Centro de Salud. Rosa graciously agreed to continue sanitation education and to take on the latrine and cook stove projects with Pico Bonito. She has also requested an additional 300 speculums for cytology exams.

In the afternoon, we had the opportunity to examine the water cisterns with the new chlorination systems in La Hicaca and Chorro Viento. We drove to La Culatta and climbed up to Chorro Viento. The 45-minute hike was definitely not an easy one and made me appreciate the 5-6 hour journeys many people endure to come to the brigade. Below are some pictures of the cisterns and the chlorination system installed.

New chlorination system in Chorro Viento

We attended Mass on Friday evening, traveled back to San Pedro Sula Saturday morning, and flew back to the US on Sunday. Although a short trip, we have gained a substantial amount of knowledge on current programs implemented in La Hicaca and surrounding villages.

I cannot wait to return in June- to see the progress and of course, to see my friends.

VCU's Global Health & Health Disparities Program Sets Off for Honduras (Again!)

Traveling to La Hicaca 

Our group leaves this Sunday to meet with our community partners and the local Ministry of Health in Yoro, Honduras. We have traditionally used our January trip to meet with our key partners, review information from the prior brigade and to help lay the groundwork for the subsequent large-scale, clinical brigade in June.

Since 2008 we have been serving a series of 17 villages with approximately 2,000 people in rural, mountainous northern Honduras. People in the region have little to no access to healthcare and suffer from fundamental environmental health pressures (such as lack of access to clean water and latrines). 

We have a large-scale water filter program in the region that has been active since 2008. To date we have distributed over 350 water filters, each of which can provide clean drinking water to an entire family for 2 years (or more). We estimate approximately 75% of the people in the region have access to clean drinking water as a direct result

Preparing water filters for distribution 

of this program. Anecdotally, less children are developing (and occasionally dying from) diarrheal illness. More objectively, the incidence of severe diarrheal illness reported to the Ministry of Health has halved since the inception of the program. 

One of our projects this past June, a Chagas disease knowledge and attitudes survey, was performed at the request of the local health ministry. Chagas disease is a parasitic disease that is common in Latin America and is associated with severe cardiac and gastrointestinal morbidity. We will be sharing the results of the project with our partners this upcoming week; we are excited to discuss study implications and next steps.

Working on the indoor air quality project

Two years ago the health ministry and local leaders asked us to investigate the problem of indoor air pollution. A now-third year VCU medical student, Audrey Le, formally assessed the issue and found certain home characteristics were associated with respiratory symptoms. Subsequently we discovered many stoves were in a state of disrepair and not effectively ventilating smoke. This upcoming week we will be meeting with a local non-profit organization who may be able to help repair these defective stoves; we are excited about this potential collaboration.

Additionally, we are excited to discuss several upcoming surveys we hope to administer in June: looking at knowledge, attitudes and risk factors for intestinal helminth (worm) infection and a survey on women's health issues. We also are partnering with a VCU undergraduate group, Engineers Without Borders, to explore a novel rain catchment technology (to help provide clean drinking water) and will be conducting a survey focused on barriers for optimal use of water filters. 

Clinic in Lomitas

During next week's trip we will also be supplying anti-helminthics to help bolster regional efforts for intestinal worm control. We will also be doing the groundwork for our upcoming clinical mission; figuring out key logistics such as clinic space, how to recruit patients, et cetera. 

I will post about our trip either during the trip or shortly thereafter; stay tuned. Dr. Gonzalo Bearman will also be posting about the experience, be sure to check out his blog. You can also follow our progress on twitter here. 

"Rams Reaching Out" Exhibit: Highlighting VCU Health Science Students' Outreach Work

For anyone in and around Richmond, there is a cool exhibit on display at the Tompkins-McCaw library. The exhibit includes photographs from VCU students who have participated in health outreach efforts (and highlights activities in rural Virginia, El Salvador, Peru, Honduras, Costa Rica, Togo and other places). Definitely a lot of good work going on and worth taking a look at if you are in the area.