San Pedro Sula, Honduras
By Lourdes Ramirez
When Covid19 began to infect millions of people in the world without distinction of social class, it was said that rich and poor alike were exposed. But that equality was not reflected in access to health services and the vaccine in Honduras, which was available from December 11, 2020, for the rest of the world. but Hondurans had to wait until February 15, 2021.
In Honduras, a nightmare from which many did not wake up
Official data up to October 19, 2022 register, in Honduras, the death by Covid19 of 11,007 people, and about 457,000 confirmed cases. Recent deaths, according to authorities of the Ministry of Health, are due to unvaccinated patients. Likewise, to people with pre-existing diseases such as hypertension, diabetes, kidney failure, among others.
Don Evaristo Gómez did not live to tell about it, he was one of the older adults who failed to survive covid. His son, Héctor, fought for a place in hospitals, his story reflects the experience that thousands of Hondurans went through.
“At one in the morning my father began to convulse; he did not remember anything; he had received the second dose of the vaccine. Those days he had a cold, he had a lot of cough and flu, he was about to faint twice,» says Héctor.
I told him I was going to take him to a hospital, but he didn’t want to, on the fifth day I saw that he couldn’t breathe; he didn’t tell me anything. At night he began to pray and repeat the same prayer, something he had not done before. I worried even more. I began to look for how to transfer him to the hospital, and my father was just delirious, «explained Gómez.
Moments of anguish for the Gómez family due to Covid 19
Before arriving at hospitals, patients must pass through a primary care center «Triage» so that health personnel can define the severity of the patient. On the highest days of contagion it was very difficult to get a place in hospitals; many patients died in their vehicles connected to oxygen tanks, waiting for a place.
“We arrived at Triage at 3 in the morning. A nurse told us that all the rooms were full. And I began to beg her. A doctor arrived, I told them, almost crying, that we had come from far away and my father needed help. The doctor said that there was no oxygen for all the patients. After insisting so much, I managed to get him treated and they placed a manual device on him, and my father began to breathe better,» said Héctor.
And he added «My father was in a corridor and at the change of shift someone came and said that they could not attend to him because they were giving priority to young people. I already knew that I had to find a way to admit him to a hospital. there were supplies and I had to ask friends for money to buy what I needed. I had already seen my father-in-law die months before in the same place.»
Families assumed costs and medical risks
The needs were multiple and only family members who could cover the costs of medical tests and the purchase of supplies, such as oxygen masks, could survive.
While they managed to get a place in public hospitals, families with greater economic resources could admit patients to private hospitals, but they also faced a lack of places. Some doctors took risks and treated patients at home given the prevailing emergency conditions.
Thanks to Héctor’s efforts and the calls for help he made on his social networks, a lawyer friend managed to get Don Evaristo admitted to the Leonardo Martínez hospital in San Pedro Sula.
Moments in which Don Evaristo is transferred to the Leonardo Martínez Hospital. Photo by Hector Gomez.
“It was very cold, he practically said goodbye to me, he told me that, if it was from God, he would leave the hospital, if not that I behaved well. I had to buy all the supplies, they asked me to take laboratory tests,» narrates Don Evaristo’s son.
Héctor spent several days in the hospital waiting for his father to improve, days in which he saw many patients, arriving and leaving there, some in coffins and others recovered, which gave him some hope.
Goodbye to his father
«A doctor made a video call to me and we could see him. He greeted me and my children, they were very sad, because their maternal grandfather had recently died, also from the virus. He looked better and hoped to leave, I did not imagine it would be the last time I would see him alive,” Gómez continues.
On September 3, 2021, at dawn, Don Evaristo passed away. He received all the necessary care, the doctors had already informed his son that after all the treatments he received for a period of time, they would take away his oxygen to try to make him breathe on his own, at that time it was not known if he was going to save or not
Doctors and nurses gave their lives to patients while waiting for vaccines for Covid 19.
The vaccines arrived in Honduras in February 2021, by which time some 100 doctors and 40 nurses had lost the battle.
For Arturo Vidal, health workers were one of the main victims of this pandemic.
They, having direct care with Covid 19
patients did not have social security and the necessary antiviral medications did not exist to protect themselves from the virus.
«Some of the colleagues who died already had morbidities, but also many of them were young doctors and were not at risk for other morbidities, but due to this deficiency, they lost their lives,» says Dr. Arturo Ávila, director of Mario Catarino Rivas hospital.
How many people have been vaccinated in Honduras?
The effectiveness of the vaccines has been demonstrated, according to data provided by the Ministry of Health, exceeding 15 million doses applied. Due to vaccination, a significant decrease in hospitalizations for Covid-19 has been reported.
“People who have died from Covid-19 had an incomplete vaccine table, so those who have not yet completed the scheme are expected to go to the 1,600 sites enabled between Health Centers, hospitals, fixed and vehicular posts. ”, detailed Dr. Aron Bueso, coordinator of communicable and non-communicable diseases of the Ministry of Health.
This is how vaccination progresses in Honduras
Vaccines continue to arrive to inoculate more than 70% of the population. According to data from the Ministry of Public Health. Until October 17, 2022, the amount of 16,211,055 doses were administered, applied to 5,679,402 people, which represents 62% of the population, of 9.5 million inhabitants.
At the Mario Rivas Hospital there were 0 patients with Covid19 in the last 10 days in San Pedro Sula and in Tegucigalpa at least 35 hospitalized patients were reported, the health authorities reported this day, a decrease of 96% in cases of Covid-19.
Honduras continues to receive vaccine donations from friendly countries
On Friday, September 16, Honduras received 184,320 doses of Pfizer vaccines against COVID-19; they were donated to Honduras by the Belgian government through the COVAX Mechanism, which arrived in the country in 4 deliveries on days 13, 14, 15 and 16 of September.
Through the COVAX Mechanism, Honduras has received 27 deliveries of doses of vaccines against COVID-19, for a total of doses of vaccines against this disease. This is the first delivery made by the Belgian government.
The United States, an ally in donations to Honduras
Likewise, the United States government makes a new donation to Honduras of 358,020 doses of Pfizer vaccines against COVID-19 for adults. The vaccines will be arriving in the country in various shipments this and next week.
This vaccine donation, like the previous ones, was made possible through the COVAX mechanism and is part of the global effort of the Obama administration to save lives and end the COVID-19 pandemic.
This equipment donation was made possible by funding from USAID’s American Rescue Plan Act. This donated equipment includes 51 desktops, 5 laptops, 53 multifunction printers, 54 uninterruptible power supplies, 24 barcode scanners, and two servers.
With this new delivery, the United States has donated more than 5.8 million doses of vaccines to Honduras since the start of the pandemic. USAID Mission Director Janina Jaruzelski said:
“These vaccines are available to everyone, regardless of whether they live in the city or in the countryside. For anyone who is not fully vaccinated, get your shot today!”
The United States government made the donation as part of a joint effort to address the challenges posed by the COVID-19 pandemic in the hemisphere.
This vaccine donation is the most recent example of several donations made and delivered since March 2020.
The United States government is committed to ending this pandemic through global cooperation to ensure that the largest number of safe and effective vaccine doses reach the largest number of people around the world as quickly as possible.
The health system was collapsing and the pandemic worsened care for other diseases.
According to the director of the Mario Catarino Rivas hospital, Dr. Arturo Ávila, the Honduran public health system was collapsed at the time the pandemic entered as a result of the application of the neoliberal measures that have been applied since the 201 years of independence. These measures were deepened in the 80’s through what was called structural readjustment.
«The measures that tended to privatize all the institutions and all the services that the State must provide to the population were intensified, health was not the exception,» says the director.
All State institutions became more precarious and at the time we faced the pandemic, there were very precarious conditions in our health system, which were overshadowed and were not publicly evidenced, ”says the doctor.
The pandemic exposed conditions that already existed
He adds that the complex circumstances that were in the health system were not visible; that the pandemic came to expose those critical conditions in which our hospitals were found; and that the doctors did know and did expose them in the few opportunities they had.
From that collapse, many protests took place between the unions of the health sector and the education sector, before the pandemic, «we made a movement that was called the fight against the privatization of health and education, in which both unions joined and we faced multiple struggles”, he explained.
A critical voice against the health system
From the medical union there have been criticisms because they maintain that from political power, there is not enough attention to the needs of the health system.
Among the criticisms, according to the Director of The Mario Catarino Rivas Hospital, are:
Infrastructure is neglected.
- There is precariousness in the health system.
- Medical equipment and the supply of medicines in stores were neglected.
- The foregoing, according to the director, explains the reduction in the workforce of all health institutions, doctors, nurses, specialists, auxiliaries, nursing graduates, and laboratory personnel.
Under these conditions, health personnel faced dire circumstances that caused the impact of this pandemic to cause greater damage in relation to the rest of the countries.
«For example, the mortality rate of our medical colleagues was one of the highest in Latin America, due to the fact that we did not have a robust health system and we did not have all the protection mechanisms that should be applied,» Ávila explained.
To which he added that:
«In these circumstances, we thank the doctors and nurses and all the health personnel who were able to get ahead and face the pandemic. But there is no doubt that the complex and dire circumstances we were in allowed the impact to be greater at that time» .
«They didn’t even give us masks»
The medical personnel in public hospitals such as the Mario Rivas Hospital in San Pedro Sula or decentralized hospitals such as the Leonardo Martínez Valenzuela, did not have access to all the necessary requirements to care for patients.
“During my first shifts, they did not even give me a mask. I had to wear a surgical mask to enter the Covid-19 room, and then it became normal. Apart from that, I had to buy my own personal protective equipment with a mask, which I did this to protect myself. but the institution didn’t even give us masks,» explains Edgardo, a front-line doctor during the most critical months in 2020.
In addition to the risks of contagion and work overload, the pressure on the medical staff was not only due to the lack of supplies to care for patients and not having all the necessary biosafety equipment, but also the late payment. Of their salaries, which led to public protests, to put pressure on the authorities.
“During the toughest stage of the pandemic, I treated a dozen patients in serious condition, high flow, and intubated patients. On days when work was less, he attended two to three seriously ill patients per shift, critical patients who had to spend more than an hour continuously on each one to see the patient’s condition and see what decisions to make,” the doctor details.
Family members of patients could not accompany them at the time of their death
At the beginning of the pandemic, authorities from the Honduran Medical Association, as well as recognized epidemiologists, tried to make the population aware of the care they should take to avoid becoming infected, they anticipated that the lack of resources in state hospitals would force them to decide to who give access to mechanical ventilators or oxygen tanks and medications, to a hospital bed. This point was consulted by Dr. Edgardo, who did not deny that they were in this dilemma.
Frontline doctor Edgardo made it easy for patients to talk to their families through video calls when he was still able to communicate. It was he who communicated with Mr Evaristo Gómez with his son and grandchildren so that they could say goodbye.
«I had to decide on people’s lives»
“To be honest, I have had to decide on people’s lives and I think it is one of the things that has affected me a lot. Now I understand that it was not my responsibility,» said doctor Edgardo.
Whenever a patient was presented to me to see if I would give him an intermediate quota, my question was: how old is he? Does he have a chance to live? And according to that he gave him the quota or not. One takes it on the basis that the older person has already lived, loved, had a family, had experiences. And the young patient has small children at home; he has to fight to be able to get those children out of the house,» the professional reflected.
According to the doctor’s account, there came a time when the patients arrived in pails from the vehicles, with the oxygen cylinders at the maximum level, they arrived at the hospital to be admitted, and there was no possibility because there was no way to attend to them.
They told relatives to take them home and to call the hospital the next day to ask if there was a space. But deep down the doctors knew they were sending them home to die, because maybe that very night they were going to die.
“Before that tormented me, it tortured me to think about it, but not anymore. Because I know it’s not my fault, that it’s not my responsibility and I’ve tried to help as many people as I can,» added the doctor.
There is discomfort with the Government of Honduras
The qualifying terms against the Government of Honduras for the poor way in which the pandemic was managed are multiple.
The doctors who have been on the front line caring for patients in the Covid rooms consider that the coordination of the pandemic has been “fatal, terrible, deplorable, postponed, postponed, terrible, it has been a joke the handling of the pandemic by the Government,» says Jesús Edgardo, a doctor on the front line of care in Covid.
Likewise, he comments that the Government has dedicated itself to talking about figures, which for him are not true, since his contact with them has shown him another reality.
For this first-line doctor, the Government has been «accomplice in the death of many patients, because:
- They did not supply care centers as they should.
- They did not deliver enough supplies.
- They did not enable more quotas than were necessary.
- No more fans connected.
- The oxygen supply has been insufficient.
All of the above, for this professional, has been insufficient in the 20 months that he has been attending to the pandemic.
Giving the bad news, a job for doctors
One of the factors that most affect medical personnel is when they have to tell relatives of patients about the seriousness of the disease.
«On many occasions I have had to break the news, I do not remember the number of times I have had to break the news to a family member and practically, to be honest, one always says this is the uncomfortable moment,» says Jesus.
«Personally, I try to be empathic, but I don’t give it that much detour before saying it, with prudence, but without wanting to embellish it too much,» Jesús describes.
The impact of corruption during the pandemic is incalculable
In addition to the notable deficiency of the health system, there is also a negative impact on the country’s economy, due to the corruption that occurred along with the measures adopted to combat the virus, according to the National Anticorruption Council (CNA), through of the investigations carried out, an economic loss caused by corruption in the context of the COVID-19 pandemic was identified: Three thousand four hundred and forty-eight million, three hundred and twenty-six thousand two hundred and one and zero six cents (3,448,326,201.06 lempiras), One hundred and forty thousand million, five thousand one hundred twenty-three and 87 (140,005,123.87 dollars)
Likewise, a study named: Measurement of effectiveness and transparency in Central America: How did the States use the resources to counteract COVID-19?; establishes a relationship between Honduras and the other countries of the Central American region, determining the use, effectiveness and transparency in the management of funds allocated by the state for the purpose of addressing the health emergency caused by COVID-19.
Covid 19 brought to light the main problems of the country.
The deaths of people in conditions similar to those of Don Evaristo, the efforts of medical personnel, the lack of supplies in hospitals and acts of corruption, were some of the situations that the country had to go through since COVID 19.
Even so, there is hope among citizens and the state with the arrival of the vaccine, which has given medical centers a break.
However, it leaves a concern since Honduras is considered one of the poorest countries in Latin America, surpassing only Haiti, and after the experience of the pandemic, no progress has yet been made in restructuring the public health system.
Nine months after the installation of the new government of President Xiomara Castro, no major changes have been observed in the administration of the health sector.
Considering that the country faces other epidemics such as dengue and other preventable diseases that are not a priority despite the public health cost, the arrival of another pandemic or greater natural disasters due to hurricanes or climate change would be devastating for Honduras.
