Honduras - Special Report

REPORT ON MAP INTERNATIONAL'S RELIEF RESPONSE
TO CENTRAL AMERICA
AFTER HURRICANE MITCH

Hurricane Mitch was Central America's worst natural disaster in this century. Thousands died, and an estimated 1.7 million people were left homeless and vulnerable. The economies of Honduras and Nicaragua were devastated. Some estimates place the damage to the economy and infrastructure at over $5 billion (U.S.). And so it is fitting that MAP International launched one of its largest disaster response efforts in its history to respond to health needs in the wake of this tragedy.

In the four months since the hurricane hit, MAP International shipped and arranged for distribution of over $22.8 million (wholesale value) in medicines and medical supplies. This amount equals the volume MAP normally would handle worldwide during the same period. The equivalent of sixteen 20' sea containers carried life-saving medicines and hospital/surgicalsupplies destined to be distributed by some of the largest and best known international relief and development agencies with work in Nicaragua and Honduras: World Vision; Food for the Hungry; Mercy Corps; CARE; and Operation Blessing to name but a few. These were joined by indigenous groups like CONSEDE, an umbrella Christian organization. Also included in this total figure was 377 MAP "travel packs" and 60 "specialty packs" hand carried to the disaster site by dedicated health professionals and missionaries.

A MAP relief team, headed by MAP's Latin America regional director (a Honduran) left MAP's Ecuador regional office for Honduras November 11 and stayed in-country until the 29th. In addition to MAP staff, the team was comprised of medical/health professionals and crisis intervention specialists who sought to provide crisis counseling training for those working with the survivors of the disaster. Drs. Esly Carvalho and Eduardo Campana trained facilitators in crisis intervention and emotional recovery, using a model disseminated by Gilberto Brenson, Ph.D., a noted expert who first developed materials for use with the victims of the Ruiz Volcano disaster that wiped out the village of Armero, Colombia in 1985. During their week in Honduras (November 11 - 17) the trauma counseling team led seven workshops in Siquatepeque, Comayagua, Tegucigalpa, and La Libertad. The Honduran Ministry of Health officially recognized the success of their efforts. The MAP sponsored emotional recovery/trauma counseling initiative was recognized as one of a very few programs of its kind, responding to the mental and spiritual as well as physical state of the survivors.

A second MAP team, including president Paul Thompson, arrived in Honduras December 9th to follow up on MAP shipments and to assess their management and distribution to date. There did not appear to be any major logistics-related difficulties with the shipments to Hospital Evangelico, CONSEDE or World Vision. Inventory control and management viewed during the assessment trip appeared to be adequate to the task.

While in Honduras, a second objective was to meet or contact the ministry of health officials, USAID, and PAHO officials, as well as Hospital Evangelico staff in Siguatepeque. The hospital has been a major recipient of MAP-donated supplies in Honduras for several years. MAP has also been instrumental in assisting their community health outreach with financial and manpower resources. Dr. Enrique Martinez, the hospital director, explained the impact the MAP donations had on their relief work:

"It is good to have an organization (such) as MAP. In our case we knew beforehand that they could give us an immediate response to our request for medicines because they have a stock of them and because they have supported us from a long time ago in many projects that we have carried out and some that are being carried out now. To make a direct purchase of these medicines is very expensive here, but not only that, during Mitch many drugstores or pharmaceutical companies of Honduras went down with the flooding and there was no choice and until now there are many medicines that cannot be found. We have had to provide with these medicines to public health centers and isolated places in Honduras."

On December 14th, the team met with MOPAWI staff. MOPAWI is an indigenous, Christian organization working in La Mosquitia region of Honduras and has achieved considerable progress organizing programs with the communities in health, sanitation, potable water, and agricultural improvements. MOPAWI temporarily reoriented the majority of its activities to emergency relief and rehabilitation in the region. Through their efforts, MAP-donated supplies were distributed in this most remote area of the country, accessible mainly by small plane and boat. Mercy Air played a key role in transporting MAP medicines to this remote area.

MAP remains involved in the rehabilitation process for the region. As emergency medical relief dries up and stocks of disaster supplies dwindle, MAP is working with sister agencies to ensure that future shipments of medicines and medical supplies are in the pipeline.

The trauma counseling and emotional recovery work continues as those trained by the MAP-sponsored group continue to replicate their workshops and training. Likewise, MAP continues to work with Hospital Evanglico through their community outreach programs. MOPAWI has expressed interest in undertaking water projects in the near future, and MAP has agreed to help facilitate the process. Additionally, MAP has established four self-sustaining "mini-pharmacies" in four Honduran communities. Plans include adding health promoter training and training in rational drug use in the future to strengthen the impact of this work.