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Q&A with Global Links’ José Henríquez

Ciriboya Hospital Inauguration 002

As the Program Officer to Central and South America, José Henríquez works with Global Links to improve public health and strengthen regional healthcare in Latin America and the Caribbean. Recently, Global Links and Henríquez have focused on Honduras’ Garifuna communities –descendants of Carib, Arawak and West Africans — to provide health care.

Henríquez engaged in a Q&A with Los Afro-Latinos via email to speak about Global Links’ work, Garifuna communities and how we can help Global Links advance healthcare for those in need.

Los Afro-Latinos: What is Global Links’ mission?

José Henríquez: Global Links (GL) is a Pittsburgh-based medical relief and development organization established in 1989. We have a two-fold mission: (1) We work to improve the health and lives of people in resource-poor communities, particularly in Latin America and the Caribbean and (2) We provide hospitals in our region with a socially and environmentally beneficial alternative to disposing off tons of still-useful surplus materials.

In developing countries, hospitals and clinics serving the poor often lack supplies and equipment to provide basic care, resulting in needless suffering and deaths. At the same time, the U.S. healthcare industry generates a staggering amount of medical surplus which, without intervention, is destined for disposal.

GL’s innovative model of recovery and reuse connects these two social problems in a way that helps to solve both, creating a “virtuous circle” that converts an environmental burden to a life-saving purpose.

LA-L: When and why did Global Links decide to serve Garifuna communities?

JH: Global Links started supporting Garifuna communities in 2007. Through its long-term collaboration with Cuba, our organization got in touch with the Latin American Medical School (ELAM by its acronym in Spanish) and with its graduate students. Among the doctors of the ELAM’s first class was Luther Castillo Harry, a Garifuna, from Honduras. After he went back to his home country, he moved ahead with his dream of building a health facility where there had never been one before, and to provide health care services for the Garifuna people by doctors who speak the language and share their culture. Global Links understood that this was a truly comprehensive and impressive public health endeavor and offered to be part of the initiative.

Dr. Luther examining a little girl. Photo courtesy of José HenríquezLA-L: What is Dr. Luther Castillo’s project?

JH: In 2001, UNESCO (the United Nations Educational, Scientific and Cultural Organization) proclaimed the Garifuna language, music and dance a Masterpiece of the Oral and Intangible Heritage of Humanity, but Garifuna communities in Honduras have traditionally had only very limited social services (health, education, water or electricity) as part of long-term conditions of poor social and economic development. Those conditions have historically kept those populations under systematic risk and vulnerability. After graduating from the ELAM, Dr. Luther Castillo started the Foundation “For the Health of Our People” (Luagu Hatuadi Waduhenu in Miskito language, which he actually leads as CEO) and worked to create the first Garifuna hospital.

With a remarkable collaborative effort and a fantastic involvement of the communities, the hospital was built and officially inaugurated in December of 2007; Global Links furnished almost entirely the first phase of the hospital, and its staff was fortunate to witness that key moment in Garifuna and Honduran history. After that, Dr. Luther, together with the Cuban Medical Mission in the area undertook a second phase in which the Cubans donated x-ray equipment, ultrasound, and other laboratory machines, as well as Cuban personnel to run the machines,  to make it a more comprehensive diagnostic center. At that point the hospital in Ciriboya was added to the public health system, allowing it to have resources to pay for much-needed personnel, medications and supplies (however this status was reversed after the Honduran coup-d’état of 2009).

Looking to the future, Dr. Luther’s foundation has already developed plans for the extension of the facility which hopefully will become a regional hospital. Among the core principles of this project is the fulfillment of health as a human right among Garifuna communities, and a healthcare approach based on community, prevention and cultural pertinence.

LA-L: Where are the Garifuna communities Global Links serves? What are the health conditions?

JH: Iriona is a rural municipality in northern Honduras, department of Colón. It has 67 communities with a total population of 25,000 inhabitants of which a larger portion is very young; 49% was estimated to be under 15 years of age in 2010, and only 3% was estimated over 60. Health conditions in Iriona reflects this demographic distribution as well as the poverty conditions in which they live: intestinal parasitism, acute respiratory diseases, diarrhea, anemia, dermatitis, and malaria are among the top ten causes of morbidity – all of them communicable diseases. Numbers of cases keep being underreported as health coverage has been traditionally limited. Maternal and infant mortality are still a problem due to lack of doctors and nurses, and also because of limited training of communities’ midwives. However, the Garifuna hospital is helping to reverse that situation.

LA-L: What are the challenges to serving these communities? (i.e. location, Garifuna language and culture)

JH: Presence and investment of the state have been historically absent from Garifuna communities and that reflects in poor road infrastructure – with almost nonexistent paved roads, and lack of running water and electricity services. Those conditions make serving Garifuna communities not always an easy task. Accessing many communities takes long hours either by car/foot on rough tracks or by boat, and this simply can be a matter of life and death in an emergency situation. Something that may seem so simple like sending materials to support their efforts becomes very complicated because of transportation availability and costs.

On the other hand, due to limited educational opportunities in the region, there are few Garifuna doctors and medical personnel have traditionally come from outside of the region. That situation has been challenging for the communities, as those health servers – even being fellow Hondurans, did not know the language or were not familiar with the cultural setting.

Garifuna hospital when it was being built (2006). Photo courtesy of José Henríquez.

LA-L: How many times have you visited the area? What was the goal of your recent trip in November 2011?

JH: Global Links staff has visited Ciriboya several times, one of them to participate in the opening of the hospital. Dr. Luther has also visited our headquarters a few times to discuss further collaborative efforts with our organization. In the last trip, although the main goal was to visit Miskito partner communities, I also met with Dr. Luther to keep current on the situation of the project and to plan for support in 2012.

LA-L: How has the hospital changed the communities?

JH: Since the hospital’s opening it has attended around 300,000 patients. Between May and July 2011 only, the hospital attended 18,740 people, a third of which was served domiciliary; these numbers reflect the huge contribution of this project to the whole region. It has to be added that the hospital offers free services, something extremely important in a region with widespread poverty. People’s health has improved through reduction of maternal and infant mortality, attention to chronically ill patients, laboratory exams, ultrasound imagery, odontology, gynecology, and pediatric services.

LA-L: What is the most pressing need or challenge for Garifuna communities?

JH: Paraphrasing the concept of human development, Garifuna communities need to reach an environment in which they can develop their full potential and lead productive, creative lives according with their needs and interests. That means to see an end to their poverty and a path to sustainability in which they will have the starring role; nobody else could give the most accurate words to describe their goals and dreams. However, they cannot do that alone. There is a historic debt of the Honduran state towards Garifuna communities, and one of the most important changes has to happen on that side.

A significant event, the 1st Global Summit of African descendants held in La Ceiba last August, asked in its final statement that the United Nations and other world bodies hold permanent forums on improving their communities’ economic and social conditions. It also called on the U.N. to create a development fund to fight poverty and protect the human rights of Afro-descendants; and it also demanded justice for victims of racism. This has to be a collective endeavor.

Garifuna hospital the day of its opening (2007). Photo courtesy of José Henríquez.

LA-L What is the Ciriboya project?

JH: The health project in Ciriboya is really ambitious – it has many reasons to be, and it goes beyond the services provided at the hospital. In addition to that they are engaged in doing research to advance the knowledge and treatment of certain health conditions among Garifuna communities. For instance, they have completed a study on breast cancer in the area, and now are in the process of preparing studies on sickle-cell anemia, cervical cancer, and chronic kidney disease. Another way of collaborating is to offer financial support to these projects; they are definitely innovative and will open new windows to health services among Garifuna communities.

The demand of services and the poverty in the area put significant financial pressure over the project, especially after the government of Honduras did not renew the contract with the hospital and left it out of the system. A good way to collaborate is to offer financial support so they can have resources to buy supplies and medicines, but also in order to sponsor the nursing staff, which actually works ad honorem, even if they have families dependent from them.

LA-L: What are Global Links’ future plans and goals?

JH: Global Links will continue supporting the Ciriboya project – its medical services as well as its research efforts. This is part of a larger commitment of our institution to support underserved communities in Latin American and Caribbean states. Supporting Garifuna communities in Colón as well as Miskito communities in Gracias a Dios, in dialogue with the communities, the Pan-American Health Organization/World Health Organization, and the Ministry of Health is a priority for our institution in 2012.

To learn more about Global Links or make a contribution visit their website: www.globallinks.org

To offer your support, please contact: Dr. Luther Castillo Harry, Founder and CEO, Luagu Hatuadi Waduhenu at wasurusian@yahoo.com

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