Honduras is a small country located in Central America bordered by the Caribbean Sea in the North and the Pacific Ocean in the South

Honduras is a small country located in Central America bordered by the Caribbean Sea in the North and the Pacific Ocean in the South. It is beautiful and ecologically diverse, with a growing eco-tourism base, but also economically disadvantaged. According to The World Bank, more than 60.9 percent of the population in Honduras lived in poverty in 2016. At the same time, it was mentioned that in the rural areas of Honduras, about one in every 5 Hondurans live in extreme poverty. The rural areas in Honduras depend mainly on the agriculture and dairy industry for sources of income. Honduras has only two main seasons. They have a dry season, during which time some of the crops can die mostly because the majority of small farmers do not have irrigation systems and rely on the rain or diverting water from the rivers. They also have a rainy season. During the rainy season the country often experiences large tropical storms with high winds, including hurricanes, and flooding. In either season, the hard conditions affect the food sources, income, and conditions of living of the population. The largest production of land crops are bananas, plantain, coffee, sugar cane, and pineapples. The dairy farms are for the most part small family owned and managed farms the produce milk, sometimes cheese, and sour cream. Most of their milk is transported to the processing plants located in the nearest town. Honduras also has a large fishing and fish farming industry producing shrimp, tilapia, lobster and conch.
The living conditions in the rural areas vary greatly, with some areas having electricity and running water while others depend upon rain catchment or the local river for water and generators, oil lamps, or the sun for lighting. The housing construction also is very diverse as some homes are constructed from concrete blocks or milled lumber while others are constructed by hand from homemade adobe, rough cut wood from the surrounding vegetation, and roofed with corrugated galvanize steel or alternately, palm fronds. The housing is sometimes located on the same farm for which the laborers work. Some laborers ride their bicycles to their work place which may be located sometimes one to three kilometers from their homes. Another part of the economically disadvantaged population lives close to, or within, the city limits. This group normally live close to the river beds or to the bridges and wander into the city to eke out a subsistence living by beggary or selling papers, fruit, washing windows or seeking transient labor opportunities. These people are known as “marginales”. Their housing is mostly made from discarded cardboard, plastic, poly tarp tents, and corrugated galvanized steel. They do not have access to basic public services in their communities and rely on the water from the rivers to do laundry, wash dishes, cook, and bathing. The cooking is mostly accomplished with wood scavenged from the city or harvested from the surrounding vegetation.
In general, Honduras is not a country with good, affordable, or easy access to healthcare. The population in the rural areas in particular, do not have access to the best healthcare centers or schools, and are often forced to rely on seasonal produce for eating. These conditions lead to a decreased likelihood of adequate prenatal care in women of childbearing age. The perinatal deaths can be directly associated to the lack of sufficient healthcare services, poor and or non-existent prenatal care, and sub-standard delivery conditions, with a vast majority of women in the rural areas relying on a midwife (partera), to deliver their children. A child delivery under these conditions can cause hemorrhage or other birth complications resulting in the death of the mother or child, while childhood mortality rates can also be directly related to a lack of healthcare access and nutrition. Most of these communities lack good roads, they have limited access to private transportation, and they cannot afford to pay for hospital admittance. According to UNICEF (2003), children under five years of age and maternal mortality rates are very high and over one-third of infants suffer from malnutrition. It was mentioned, that about 18 percent of the population has no access to public health services and the HIV incidence rate is 1.8 percent, the second highest in Latin America. According to the Pan American Health Organization (2017), perinatal disorders are ranked as 19% for mortality rates while congenital abnormalities account for another 6% of deaths. The Centers for Disease Control and Prevention (2013), listed for Honduras under the top causes of death as number one being perinatal conditions at 16% and number ten being HIV/AIDS at 2.5%.
The US Department of State (2005), stated that human rights problems involved violence and discrimination against women, abuse of children, and child prostitution. Honduras violence is high and there are certain areas in the city that is not recommended to visit, since these areas are controlled by the different maras (gangs). According to Speizer, Goodwin, Whittle, Clyde and Rogers (2008), child abuse occurs before the child reach 15 years of age. Abusers tend to be a family member or neighbor. This study mentioned that women who have suffered from sexual abuse were possibly in a violent relationship. The authors concluded that a child that has been sexually abused might experience a long-term negative health impact. While not explicitly addressed, we should assume that some of these instances of child abuse are resulting in the pregnancies of juvenile females, along with the increased risk of miscarriage, premature delivery, low birth weight, undeveloped organs and immune systems, and maternal death during delivery that accompany births by juveniles.
During this course, we have learned about the definitions of “health equity”, the systemic cause and effect of environment, income, and cultural behaviors that impact our collective health. We have learned that our social consciousness should strive to correct these inequities for the betterment of all. During my research on this assignment, I was struck again with how apt this learning is for this situation. By seeking to improve the perinatal and postnatal mortality rates, it seems that the most effective method would be to improve the country as a whole based on education, income and health practices. While primary education has high rates of involvement, it is often underserved due to a lack of teaching resources and accountability. Honduras has many excellent secondary institutions, but they are located in the cities, and the majority of the population has limited access due to transportation and finances.
Seeking to develop an alternate subsistence income, such as goat husbandry, would provide a more consistent protein and milk source for those on the lower end of the income scale. Having a better, more reliable nutritional source would lead to less health issues, which would then enable those at the lower end of the income level, to expend more energy on creating additional income, again through the sales of excess milk or meat from their goat herds. Goats are often referred to as “the poor man’s cow” Cardona, Gracia, Braun, (2017), due to their initial low cost of ownership, and their ability to survive in harsh or marginal environments.
Honduras has historically been disadvantaged through a lack of resources, a disproportionate distribution of wealth, and an unstable political climate. Honduras receives aid from many countries, in several fashions, including a projected improvement in their health care model. According to the Pan American Health Organization, Honduras is revamping their health model to include new regulations regarding social protections and accessibility. In short, Honduras is subscribing to a health equity model, in conjunction with the international community and guidelines. How well they succeed remains to be seen.