Global Health Track
Pre-Trip Planning
Pre-trip Planning for Honduras
Department of Family Medicine, University of Rochester
Introduction
Our time in Honduras should be 12-14 days of educational fun. We will learn many things. Some of them involve:
- Practicing medicine in a resource poor environment
- Honduras in general
- Honduran culture and the people
- Some Spanish
- Something about our traveling partners
- And most importantly, more about ourselves
Traveling can be stressful. Maintaining a positive mental attitude and understanding that many things will not go as planned will ensure that everyone has a great time.
Immunizations
- Basic childhood immunizations must be up to date (Td Q10 yrs, polio, MMR)
- Hepatitis B recommended
- Hepatitis A recommended
- Typhoid - optional. Vivotif by Berna Pharm. Take 1 capsule every other day for a total of 4 doses. Complete immunization at least one week prior to exposure. As with all medications and vaccines, efficacy is not 100%.
- Meningococcal vaccine - optional, not a high risk area
- Rabies - optional, there are many stray dogs, but rabbies vaccine not indicated
- Cholera - not recommended
Medications
- Chronic medications - If you take medications for chronic health conditions, make sure you bring at least double the amount of medicine you will need. Do not pack the medicines. Keep with your carryon luggage or on your person.
- Malaria prophylaxis - Chloroquine 500 mg Qwk. Start at least one week before departure and continue at least four weeks after return. For those allergic to chloroquine, use Mefloquine 250 mg Qwk.
- Travellers Diarrhea - Cipro 500 mg BID at the start of GI upset.
- Dermatalogics - consider bringing triple antibiotic cream, steroid creams, and antifungals. As a group, we should bring enough Keflex or similar medication to treat a cellulitis or two.
- Pain killers/antipyretics - Bring some tylenol and or Ibuprofen for personal use.
- Sun Screen - YES. Do bring. Consider also bringing a small umbrella for sun or rain.
- Feminine protection – Although it is possible to purchase in large cities, consider bringing feminine personal hygiene items to avoid problems in-country.
- Sleeping aids - Consider bringing ear plugs and/or meds such as Benadryl or Ambien to get some sleep.
- Motion sickness - if you get motion sickness, you will need to bring meds. Scopolamine patches or Dramamine or Meclizine.
Disease Prevention
Tent or Mosquito bed net – Many people like to use a small freestanding backpacking tent inside a building. The tent provides protection from mosquitoes and some privacy. Please do not bring a tent bigger than 5x7 ft unless 2 people will use. If you decide against a tent, consider mosquito netting and some string to hang the net.
Insect repellant - get a DEET containing product (at least 25%). You may not need it, but it is great to have if the bugs are biting. Do not bring an aerosol can.
Water filter – Consider getting a backpacking water filter ($50-$100) and use it on all water you drink. Other members of the group may already have, so you may be able to borrow if needed. We do provide safe drinking water when in San Jose.
Clothing - Appropriate clothing can protect you from insect bites and sun burns. See below
Medical Equipment
If you have them, bring BP cuffs and oto-ophtho-scopes. Don't forget your stethescope.
Passport/Visa
A passport is required. Make sure it is current and valid for at least six months after the trip. This is a new requirement of the Honduran government for all visitors. US citizens do not require a Honduran visa, but most other nationals do.
Clothing and accessories
Temperatures vary greatly depending on where in the country you are. San Jose, San Marcos de Sierra area is often cool at night. I usually have at least one sweater and a light jacket because nights can get in the low 60's (an estimate). Santa Lucia where U. Cinn. is based and in San Pedro Sulu the temperature can often get up to 90 degrees F. Light weight clothing is appropriate there. 4-6 Tee shirts - maybe one of these being long sleeve, 4-5 pair of shorts, 2-3 cotton pants or jeans, a light weight windbreaker or jacket, possibly a rain jacket (esp. Oct-Nov, not so much April-May), a hat if you like, underwear, socks, exercise clothes if indicated, flip flops and or Tevas, a good 1-2 pair of sneakers or walking shoes that can get very dirty. Women may prefer dresses/skirts to pants or shorts. Towel, washcloth, bar soap, shampoo, deodorant, shaving supplies if applicable. Toilet paper is available in the area, but you might want to bring a roll.
Flashlight, possibly a head lamp or reading light
Pocket knife (must be in checked baggage)
Bathing
Soap, Shampoo, towel, washcloth, possibly a solar shower if you prefer warm bath water. We often take a bucket bath.
Bedding
Backpackers inflatable pad or air mattress
Pillow of some type if desired.
Consider a warm weather sleeping bag or at least a blanket. Light sheet or sleeping bag liner is all most people needed in Santa Lucia.
Fun
Novels, cards, small games, shortwave radio, CD or MP3 player etc. Consider getting a small reading light or headlight if you want to read at night when others are trying to sleep.
Money
Most people did all right with $200-$300 US. US dollars can be changed right at the airport. Do not bet on an ATM machine. It is unclear if traveller checks are accepted, but they can of course be used while in airports in the US.
Medical evacuation insurace
Medical evacuation insurance is included in the price of the trip, as is insurance for political insurrection.
Travel
Because travel in Honduras can be difficult, all participants should arrive in Honduras together. The Department of Family Medicine will arrange flights for all its members. Others may want to contact Ken Maher (ken_maher@urmc.rochester.edu) 3-4 months before going to see if Ken can include your reservations for the Rochester to San Pedo Sula flights with the rest of our group. So far, we have had no trouble getting through Honduran customs. We normally have all ground transport and accommodations arranged. Travel is usually on an old school bus. We stay the day of arrival and the day before departure in San Pedro Sula (el Progresso actually) in a basic hotel. We had a nice breakfast at the hotel and then stopped at a nice restaurant for lunch. Check the Tranportation Security Administration website: www.tsa.gov.travelers/index.shtm before packing your carry-on and other luggage. Airlines usually allow 2 bags checked, both less than 50 lbs and one carry-on. The group requests one of your two bags for use to transport medical supplies. Therefore, attempt to fit all your supplies into one bag. Army surplus duffle bags work well.
Meals
All meals were provided by Shoulder-to-Shoulder. They brought a cook in who did all the cooking. The food was very good. There are no restaurants that a gringo could eat at near San Jose, San Marcos. Some small foods like cookies and chocolate-covered bananas can be purchased in San Marcos. Vegetarians may have a much more limited diet due to limited food choices (i.e. the cook decides what to make based on the available foods and what they know how to make). Homemade corn tortias are available at almost every meal. Power bars and peanutbutter seem to be favorites of vegatarians. If you have a chocolate addiction, bring your own.
Contacting home
Our project site, San Jose, San Marcos de Sierra does not have electricity or communication options. Rancho, a town about 30 minute walk away has a phone that sometimes works. It costs about $1.30/minute to call the US. The town of San Marcos does have satellite internet access. It can be reached on foot in 1-1.5 hours, although there is no guarantee the internet place will be open when you arrive. The cost is by the hour and very cheap. There are phone and internet options available in El Progresso where we stay the first and last night.
What to expect while in country
Living Space: In November 2005, we stayed in a new school building. A simple partition was erected to separate men and women. Conditions were very simple. We slept on a cement floor and used a nearby pit latrine. Four plastic-sheet shower stalls are behind the school building for our use.
Medical work: Seeing patients is very basic. A room, a desk, a chair for the patient, provider and interpreter is all that is needed. After seeing the patient, the resident or student runs the case by the preceptor. A simple note is written with the medication plans. The patient has the medications filled at the pharmacy.
Project Site
Town = San Jose, coordinates: N 14 06.538, W 88 17.012
County = San Marcos de Sierra
State = Intibuca
Area = Southwest Honduras, near the border with El Salvador
San Jose is a small rural community composed of 8 separate villages. There are approximately 1,500 – 2,000 people spread out over about five square miles in the eight villages. The area is rural, dry and mountainous. Most inhabitants are less than subsistence farmers. Most men have to leave the area to work as migrant farm workers for 2-5 months a year. Everyone speak Spanish. Most people are thought to be descended from the Lenca Indians.
