My Experiences as a Global Impact Fellow in Honduras

By James Baraldi
University of Pittsburgh Graduate Student
Global Impact Fellow

All patients politely awaited their turns in line outside the clinic.  At about noon a small, frail old woman came in and sat down in the first chair next to the door.  Wearing nothing but a pink nightgown and matching slippers, she was dressed appropriately for the typical ninety-degree Honduran weather.  The sun shown brightly outside.  The electric fan now facing her helped a little.  But she could not see the sun because her eyelids were sealed shut.  She came here with her daughter to do something about that. Or so I thought at first.

I was volunteering with Unite For Sight in its Global Impact Corps, its international contingent that provides financial and human resources to partner eye clinics in India, Ghana, and Honduras.  Four days earlier I had flown into the capital city of Tegucigalpa.  Now the urban eye clinic’s staff, my fellow volunteers, and I were at our first outreach clinic 82 kilometers away. The village was Pespire, a small, quiet colonial town set in a river valley just above the Choluteca plain and overlapping a major highway that runs the length of Central America.  Children played between the road and their stick houses and smiled when we took pictures.  One of them played with a machete.

The outreach clinic is a maternity clinic year-round, so the uniformed staff nurses were on hand to help.  One of them, a sixteen-year old girl, gently applied rubbing alcohol around the old woman’s eyes while Víctor Montoya, the optometrist at Unite For Sight's partner eye clinic, examined some of the hundred or so other attendees of this outreach. After the nurse opened the woman’s eyes, Víctor examined them and found extensive cataracts.  He recommended surgery.  The woman politely refused, stating that if she were to undergo surgery, she would die of fright.

Despite Pespire’s proximity to the highway, it is essentially in the middle of nowhere, one of the countless fleeting glimpses of humanity one sees in the rearview mirror on a transnational road trip.  The town’s biggest draw is La Cascada, “The Waterfall,” a family-owned restaurant prohibitively expensive to the majority of the impoverished locals, but not to most visiting foreigners. Those in Pespire heard of our coming via analog radio and word of mouth.  Many showed up as much for the novelty of the experience as for the free eye care that we were providing.  Some even dressed their best for the occasion.

We found out that the old woman was ninety years old.  Her daughter sat with her the whole time and, although concerned for her mother’s vision, knew that there was nothing that we could do or say to dissuade her from declining the surgery. The old woman believed that cataracts are just something that happens to the elderly.  When she stopped using her eyes, she stopped using her eyelids, and so they sealed shut from lack of use.  She would rather go on living without sight that than have to endure the long haul to the capital, the surgery, the (brief) recovery, and the evasion of the eventuality that she had anticipated for herself.  This is even if all of the medical and transportation services were provided free of charge, and they would have been had she accepted the surgery.

In the United States, the average cataract surgery costs $3000.  A $34 donation covers the same procedure in Honduras.  All three of my octogenarian grandparents have undergone cataract surgery.  Their vision has improved remarkably.  There have been no long-term negative effects.  Even without Internet access, they were prepared enough through regular interactions with the healthcare system to know that there was nothing to worry about. Delivering any sort of medical care or international aid is difficult.  Even with funding provided for transportation and medical procedures, even with trained volunteers and paid local eye care professionals, and even with a continuous provision of these resources in a sustainable program, there is yet that most significant of barriers to overcome: educational. 

My Unite For Sight trip to Honduras introduced me to global health.  My subsequent work as a Campus Representative allowed me to communicate what I had learned to various groups of alacritous students and to working professionals.  Before this, my areas of scant expertise were limited to my coursework in Psychology and Spanish.  Now, I am conversant enough in global health to be able to engage in interesting conversations with people who know far more and have done far more than I.  The delivery of care to poor people in indigenous isolation is a problematic issue in which I foresee future work for myself.  There is still much for me to learn, as well.