So far this year, my personal highlight has been a two-week work vacation in San Pedro Sula, Honduras, with a charitable surgery organization named Interplast. Based out of San Francisco, CA Interplast, was founded some 30 years ago by Dr. Donald Laub, a plastic surgeon from Stanford University, whose primary goal was to repair the cleft lips and palates of underprivileged children in Mexico. Since then, the foundation has expanded; annually they send over 30 surgical teams to more than 15 different developing countries. The trips range from one to three weeks in length, and provide treatment for oral, facial, urogenital, hand and arm disorders.

El Pais (the country)
The history of Honduras is similar to most other countries in Central America, in that the natives were slaughtered and oppressed by Spain, in the name of Christianity. They were finally able to achieve their independence in 1821. Unfortunately, freedom, for most of the population, has largely meant serving as pawns in the game of corrupt dictators and greedy U.S. corporations. Honduras was the first true Banana Republic and today, both United Fruit and Standard Fruit of the United States own more than seventy percent of the banana plantations in the country. Resulting in an ability to dictate, through their wealth, much of the political climate.

The average income in Honduras is equivalent to U.S. $100 a month. Private medical care is extremely expensive and although there are public hospitals in the country, even routine medical care is difficult to obtain. The hospitals are poorly funded, lack diagnostic tools and are overwhelmed with trauma. A need for continuing education, to update the medical community on advances and technology, plagues this country that suffers from a shortage of doctors and nurses, many of whom are forced to work second jobs (average nurses salary is around 300 dollars a month) to make ends meet.

The mountain town of Gracias/Gayle and Ada Louisa Milla

El Equipo de Cirujia (the surgical team)
Our mission at Leonardo Martinez Hospital, was as a plastic and reconstructive hand surgery team. We were designated to correct contractures from bad burns, birth deformities and traumatic injuries in the indigent community. Our first day was spent in the first day clinic evaluating close to 200 patients, some of them coming from rural areas several hundred miles away. In ten working days our 14-member team performed over 100 surgeries on patients ranging in age from one to 82 years old. We sometimes operated on whole families, who had been badly burned (in Honduras, the fields are burned every April to prepare for the upcoming crops, moreover, home fire code regulations do not exist.) Many patients with bad birth defects benefited from the expertise of our four surgeons. Most surprising, however, and by far the most common operation, was repairing injuries that adult patients suffered from machetes. A three-foot long knife costs less than $15 U.S. and although still routinely used in the fields, they are becoming popular as assault weapons, especially after Hurricane Mitch left many people destitute.

La Enfermera Gringa (the American nurse)
A bright light in the future for the sick and poor in Honduras, is the work of Gayle Milla, an energetic, dedicated nurse from Massachusetts. Gayle has lived off and on in San Pedro Sula for the last thirty years. She is the executive director of the recently formed Project Healthy Children (PHC) a non-profit organization that hopes to decrease the incidence of congenital birth defects in developing countries. They have gathered preliminary data from some of the underprivileged areas in the country, which indicate that a deficiency of folic acid, an essential enzyme, is lacking in their diets and may be significantly increasing congenital defects in newborn babies. This finding has been supported by several studies in the medical literature.

Dr. "Huey" Pham consults a Honduran child

PHC is planning on obtaining governmental support in Honduras to distribute folic acid to woman of child-bearing age throughout the country and to provide it as an additive in foods. By using Honduras as a prototype, PHC hopes to convince other developing countries to adopt similar practices.

Gayle has been a participant in every Interplast surgical trip to Honduras since 1983, over 40 in all. After witnessing a number of sick children that could not be cared for in Honduras, she arranged for them to be surgically treated in Boston, at no cost, courtesy of several Boston hospitals. The number of children and the complexity of their medical conditions have increased through the years. Ms. Milla has accompanied, now, around 15 children with severe congenital heart problems to the U.S. Many times, due to the urgency of the operation, she has paid for their flights herself.

A few years ago, she was escorting four Honduran children to Boston for their surgeries. After witnessing the grave medical condition of one of the youths, a pilot of a domestic U.S. airline, refused to allow him to board the plane, citing the burden he would be to the other passengers. Even after a heated discussion with Gayle, who insisted the child would not survive, if left behind, the pilot would not yield. The next day, in a Miami hotel, while awaiting new travel arrangements to Boston, the child died. The U.S. airline, to this day, defends their pilot and has never apologized.

About four years ago, Gayle encountered a Honduran peasant with a 3-week-old infant girl. After being told hours after her birth, that her heart was badly deformed and she would soon die, he had literally been knocking on doors, for two weeks, trying to find a doctor that would help his daughter. Gayle was, fortunately, able to arrange an immediate passport and transportation for Ada Louisa, whose family would soon insist that she legally adopt the child, out of fear that she would not survive in their two room, cement house with no kitchen, bathroom or running water. Within six days, Ada had her first of three heart surgeries. She is now a cherished member of the Milla family.

A badly burned patient

Diverciones (excitement)
Thankfully, Honduras wasnt all work and no play. While the other 13 members of our surgical team, on our only free weekend, chose to tour the fabulous Copan Mayan ruins near the Guatemala border, I opted for a five hour ride, on the chicken-bus to the beautiful, tranquil mountain town of Gracias, located near Parque Nacional Celaque. Once the governing seat of all of Central America, it still retains much of its colonial character with cobblestone streets and old Spanish churches. The following day, I summited the highest peak in the country, la Montana de Celaque at 9350 ft. Although not much of a technical climb, it was a steep five hours to the top (6000 ft. gain in altitude), where I often had to grab rocks and tree trunks for assistance. The trail was, at times, difficult to find, as maintenance is problematic in a thick cloud forest with an annual rainfall of over 100 inches. Nevertheless, the cool mountain climate was a pleasant break from the sweltering, tropical heat of San Pedro Sula.

Que Puede Hacer (what you can do)
As the millennium dawns, ushering in a global economy and a new technological age, we often fail to realize that the majority of the world lacks basic medical care. While we continually debate the right to health care, physician choice and who pays, for the poor in many countries, medical care isnt even a possibility. As an individual, you can make a difference. There are many organizations that send caring, benevolent individuals, to third world countries working for no pay, like the doctors and nurses who accompanied me to Honduras. All they need are your tax-deductible contributions.

Unas sugerencias (some suggestions):
Interplast
300-B Pioneer Way
Mountain View, CA 94041

Project Healthy Children
11 Newbury Street, Suite 500
Boston, MA 02116

Hay compasion en el mundo!