Pre-trip Planning for Honduras

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. Remember that time is not as important to Hondurans as it is to U.S. inhabitants.

Immunizations

• Basic childhood immunizations must be up-to-date (Td Q10 yrs., polio, MMR)
• Hepatitis B recommended
• Hepatitis A recommended
• Typhoid – not needed
• Meningococcal vaccine – not needed
• Rabies – not needed
• 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 carry-on luggage or on your person.
• Malaria prophylaxis—Not needed, unless you travel before/after the brigade on your own. Then it may be needed.
• Travelers Diarrhea—Cipro 500 mg BID at the start of GI upset. Or Azithromycin, once.
• Dermatalogics—Consider bringing triple antibiotic cream, steroid creams, and antifungals.
• Pain killers/antipyretics—Bring some Tylenol and or Ibuprofen for personal use.
• Sunscreen—YES. Do bring.
• 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 diphenhydramine or Zolpidem to get some sleep (just in case).

Motion Sickness

If you get motion sickness, you will need to bring meds (Scopolamine patches or Dramamine or Meclizine).

Disease Prevention

• Tent—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 5 x 7 ft unless two people will use. Because you are inside a building, the tent cannot use stakes that go into the ground to keep the tent up.
• Some people will be sleeping in bunk beds, and therefore do not need to bring a tent. The bunk beds have mosquito netting.
• 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). Other members of the group may already have, so check with the group before purchasing anything. We do provide safe drinking water when in San Jose, but the filter is great when going for a long hike.
• Clothing—Appropriate clothing can protect you from insect bites and sunburns. More information on clothing below.

Medical Equipment

If you have them, bring BP cuffs and oto-ophtho-scopes. Do not forget your stethoscope. Medical books may also be helpful.

Passport/Visa

• Passport is required—make sure is current. The passport must have more than six months left before expiration.
• Visa is not required for US citizens.
• Citizens of other countries may need a visa and must be obtained prior to leaving the U.S. It is the traveler's responsibility to get a visa if Honduras requires it.

Clothing and Accessories

Temperatures vary greatly depending on where in the country you are and the time of year. 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 mid 60's (an estimate) in the rainy season. Light weight clothing is appropriate there. 4-6 Tee shirts, 2-4 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.

Toilet paper is available in the area, but you might want to bring a roll for emergencies while traveling.

Head lamp is a must. Consider also a Flashlight. Most people find an LED headlamp very helpful and I would recommend bringing one.

Pocket knife (must be in checked baggage)

Bathing

Bring: Soap, Shampoo, towel, washcloth, shaving supplies, possibly a solar shower if you prefer warm bath water. There are no showers so a bucket bath with 3-4 gallons of water is all that can be expected.

Bedding

• Backpacker's inflatable pad or air mattress (more comfortable). We provide 4” thick foam mattresses. Given they sometimes have bugs, many people put these under the tent.
• Pillow of some type if desired.
• Consider a warm weather sleeping bag or at least a blanket. Usually warmer in May and colder in Oct/Nov.

Fun

Novels, cards, small games, laptop, 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. We usually have electricity so do not forget your chargers.

Money

Most people do all right with $100-$200 U.S. and most of that is spent on gifts while leaving the country. U.S. dollars can be changed right at the airport. Do not bet on an ATM machine. 

Medical Evacuation Insurance

The residency will purchase as part of your travel fee.

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. If you have unique travel needs, we may have you arrange your own flights, but you must arrive in Tegucigalpa before the main group does. You must also leave San Jose with the group (no early departures). So far, we have had no trouble getting through Honduran customs. Transportation and accommodations in Honduras are arranged for you. Travel is usually a bus or van. We usually spend the first night in Honduras in la Esperanza, a town about 1 hour from San Jose. We drive out the day before departure and stay in a basic hotel closer to the airport. Check the Tranportation Security Administration website before packing your carry-on and other luggage. Airlines usually allow 1 bag checked, that is less than 50 lbs and one carry-on. Additional bags are an added fee. You may need to carry a second bag to transport medical supplies. Army surplus duffle bags and 18 gallon rubber-made bins work well.  

Meals

All meals while in Honduras are paid for and provided by our group (except the last night). The food is very good considering the situation. 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 Rancho. 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 tortillas are available at almost every meal. Power bars and peanut butter brought from home seem to be favorites of vegetarians. If you have a chocolate addiction, bring your own.

Contacting Home

Our project site, San Jose, San Marcos de Sierra has electricity so do not forget your chargers. Cell phone service does exist in the area. We have a cell phone that members can use. Calling cards can be purchased in country to cover your cell phone use. It costs about 10-20 cents/minute to the U.S. SIMM cards can be purchased in country for some cell phones that allow U.S. phones to be used in Honduras. There are phone and internet options available in bigger cities. There is no WIFI or internet access in San Jose, except for a weak cell signal.

What to Expect While In-Country

Living Space -We usually stay in our volunteer house. We sleep on a cement floor and use pit or flush latrines. Up to 6 people may sleep in one small room in bunk beds.

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 our pharmacy, which team member organize and run.

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 7 separate villages. There are approximately  2,000 – 3,000 people spread out over about five square miles in the 7 villages. The area is rural, dry and mountainous. Most inhabitants are less than subsistence farmers. Most people  have to leave the area to work as migrant farm workers for 1-4 months a year. Everyone speaks Spanish. Most people are thought to be descended from the Lenca Indians.

Map of Honduras highlighting the San Jose region