Hospital Escuela in Tegucigalpa

Today Doctor Barbara took us on a tour of Hospital Escuela, the only public hospital in the country. It is the hospital for the poor, but it is not free. The patients do not have to pay for staying at the hospital, nor do they have to pay for surgery if it is required. They do have to pay for any tests such as bloodwork, X-rays, etc. They also have to pay for their medicine. An admitted patient remains in the hospital for several weeks on average, either awaiting surgery, receiving treatment, or simply because the patient cannot pay for the required test.

From the outside Hospital Escuela is an extremely run down building, surrounded by a fence with people crowding by the gate. Apparently the guards make arbitrary decisions whom to let inside. At least four patients share a single room. There are no curtains dividing the room, hence there is no privacy. The patients must provide their own sheets, towels, toiletries, etc. They receive one very small meal a day, and thus must rely on their family to supply them with food.

During our tour we visit two wards: the pediatric ward, and the neurosurgery ward. At the pediatric ward, many children show clinical signs of malnutrition. According to Doctor Barbara, in terms of nutrition the kids usually improve while at the hospital, but usually their nutrition declines again once they return to their homes.

A grandmother cradles her two year old granddaughter in her arms. She carried her to the hospital from very far away. The girl has a problem with her lungs, and slightly swollen face and legs. Doctor Barbara suspects she has a problem with her kidneys. The grandmother spends the nights under the child’s bed since she has nowhere else to go. There is a seven year old girl sleeping in a neighboring bed. Her father is with her. Because he is a man, he cannot spend the nights at the hospital and has to go to a nearby shelter, which is not safe for him and prevents him from watching his daughter at night.

In a nearby room a 3 year old girl wrapped in essentially in rags is crying and rolling around in the crib. She is extremely malnourished, and there are no adults attending to her. There are at least 4 other children with their mothers or grandmothers in the room. The women tell us that her mother brought her in because the girl suffers from convulsions, but the mother is now in a different ward in the hospital giving birth to another baby.

At the neurosurgery ward, we meet a man who has been at the hospital since mid August awaiting surgery to remove a tumor in the back of his scull. His wife is with him, and his surgery is scheduled for tomorrow. He will require therapy after the surgery but will receive none at the hospital. Another man is awaiting multiple reconstruction surgeries to his face after he suffered a terrible accident several years ago. He has been at the hospital since mid September, and his surgery has not been scheduled yet.

We have spent only an hour at the hospital, but it left an oppressive impression. We have only seen a fraction of the horrors inside. We have not seen the people left behind to die, because their families do not want to or cannot take care of them, or because they cannot afford the required tests. There is currently no special care for the terminally ill patients. We have not seen hundreds of people waiting from 5 am for a chance to schedule an appointment at least two months ahead or more.

On our way back to El Hogar, Raul drives us past one of the private hospitals in the city. It is a shiny modern building with tinted windows and landscaped yard. Doctor Barbara informs us that its average occupancy is approximately 20%.