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Summary

This medical ministry serves the indigenous, often neglected Miskito people of eastern Honduras. The Clinica Morava has an active outpatient service and a public health program that focuses on nutrition, vaccination, and malaria prevention. The hospital averages about 10-20 inpatients, and provides obstetrics care and general surgery.

Students must be able to function independently in Spanish, and will participate in the full array of clinical services. Clinica Morava's two full-time physicians also have masters degrees in public health and offer keen insights into the relationships between health and its social and cultural context. More than one hundred medical students and residents have worked at Clinica Morava since it was opened in about 1950.

The town of Ahuas is located in extreme eastern Honduras, about 10 miles from the Atlantic coast, and very near the city of Brus Laguna. This region of Honduras is known as La Mosquitia. The landscape is tropical, with thick forests, few roads, and many rivers. The rainy season lasts from June to September. The dry season is from March to May. Most of the year the temperature varies between 75 degrees and 88 degrees, and rarely below 65 degrees or above 95 degrees. A brisk ocean breeze usually moderates this tropical climate.

Plan to fly into the city of La Ceiba, Honduras. Taxi service is available from the airport to hotels. A reservation will be made for you at the Gran Hotel Paris in downtown La Ceiba.

Monday through Saturday there are flights from La Ceiba to Ahuas, all departing at 6 AM. You will pay for your national flight when you arrive in La Ceiba. Once you arrive in Ahuas someone will be waiting for you at the airport. It is crucial that you remember to confirm your return flight out of Ahuas the day prior to the day of return travel. If you do not confirm with the local agent, she may be unaware that you have a ticket for that date and are expecting to fly. The return flight arrives in La Ceiba at 9:30 AM. You will likely need to stay another night at the Gran Hotel Paris prior to your international departure the following day.

Americans are normally granted a visa upon arrival in Honduras to stay for up to 30 days. An advanced visa application is not necessary, and a 30-day visa can be extended. Be certain not to lose the yellow slip of paper that is stapled in your passport at the airport. This is the visa. For the most up to date information, please check the Honduran embassy website: http://www.hondurasemb.org/. When you leave the country you must pay a $27 airport tax.

Resident physicians should have a permanent U.S. medical license before coming to Honduras. Dr. Rudy will work with them in advance to arrange for a temporary license to practice in Honduras.

One should consult with their personal physician before traveling, and refer to the CDC travel website for the most up-to-date health information: http://wwwn.cdc.gov/travel/default.aspx

Travelers are advised to refer to the United States State Department website for the most up-to-date general travel information and travel advisories at http://www.state.gov/travel.

Most people of this region are Miskito, rather than Hispanic. Miskito are indigenous inhabitants of Honduras who have a distinct language, though many also speak Spanish. Most make a living as subsistence farmers. They generally travel by foot or by small boat on nearby rivers. Malaria, tuberculosis and malnutrition are common health problems.

The native language of this region is Moskito, though many people also speak Spanish. Students and residents must be able to function independently in Spanish. Clinic staff is available to translate for Mosquito-only speaking patients.

The Clinica Evangelica Morava has an active outpatient service that provides primary health care for both the local population and for those who travel to the Clinica via the River Platano. Malaria, dysentery, pneumonia, malnutrition, skin disorders, trauma and birth complication are frequently managed. Inpatient hospital care in provided for 10-20 patients at any one time. Orthopedics, obstetrical care, and general surgery services are available with limited support from laboratory and radiology. Clinica Evangelica Morava sees 5,000 outpatients and 700 inpatients each year, and attends 160-180 deliveries annually.

Women of La Mosquitia typically deliver their children at home. Or, like the perpetual rains of eastern Honduras, they pour into the Clinica Evangelica Morava with delivery complications. These stem most frequently from underlying anemia, malnutrition, and misunderstanding about pregnancy. Therefore, among the Clinica's public health initiatives, hookworm control, nutrition education, and prenatal care are very high priorities.

Transportation is very challenging in this region of deep forests. Therefore another high priority public health initiative is training village health workers. In the context of eastern Honduras these individuals provide mosquito vector control, management of common illnesses, and innovations for safe drinking water. They also play an important role in immunization and communicating essential healthcare education.

http://ahuasclinic.com/index.shtml

Clinica Morava's two physicians are a husband and wife team. Gerard Rudy attended the University of Michigan at Ann Arbor, completing public health and medical degrees, followed by a residency in family medicine at Cook County Hospital in Chicago. He began service in Central America in 1993. Norvelle Rudy, a native of Honduras, studied medicine at the National Autonomous University of Honduras, and public health at Boston University.

More than one hundred medical students and residents have worked at Clinica Morava since it was opened in about 1950. Clinical responsibilities normally include daily outpatient clinic and inpatient rounds, as well as assisting in obstetrics and general surgery. The medical staff will meet with students individually to discuss patient care and public health issues.

Room, meals and laundry are provided at a nominal cost to visitors. The food is simple but good. Rice with coconut is delicious! Accommodations in Ahuas are simple, similar to summer camp, with running water and showers. Electricity is from generators.

The only communication to Ahuas or Honduras is by postal mail or ham radio. Everyday at noon, the hospital in Ahuas communicates with a radio operator in the United States, who can pass along messages or provide a telephone/radio hookup.

INMED invites all participants to consider raising extra funds to donate to support the facility. This is not required but allows INMED participants to become involved in every aspect of medical missions.

Movies, shopping and restaurants are available in La Ceiba, but Ahuas is an isolated town without these amenities. Good conversation, board games, music, hunting and crafts comprise wholesome evening entertainment.

Lightweight cotton clothing is best for the hot and humid weather you will encounter. Clothes dry slowly; so make sure you bring lightweight material. Dress conservatively. Men should wear pants in the clinic/hospital or if you are doing outdoor physical labor, shorts are acceptable, but not above the knee. Pants are preferable. For Sunday church, men should wear pants.

Women should wear cotton skirts or pants in the clinic/hospital and pants for physical labor outdoors. Women are discouraged from wearing shorts. For Sunday church, women need to wear a skirt. Pants or shorts should not be worn by women to church. You do not need to bring a physician's jacket. If you have one and want to bring it along, that is your option.

Be sure to pack a carry on-bag that has your essentials just in case your luggage becomes lost. Also, it's usually best to bring two suitcases, each half full. This way you will have space to pack souvenirs for the return trip.

Please Bring: A Great Attitude!

• Documentation:
  • Passport
  • Small English/Spanish dictionary
  • Cash: for sodas, snacks, postcards
• Clothing:
  • Sun hat, sunglasses, swimsuit and towel
  • Hooded poncho and/or umbrella for rain and boat travel.
  • Comfortable work shoes, sandals and flip flops for the shower.
• Hygiene:
  • All toiletry products you will need.
  • Wash cloth and towel
• Supplies:
  • Bug repellant for clothing and skin
  • Flashlight/batteries. Electric generator is off by 9:00pm
  • Camera/film/batteries. These cannot be bought in Honduras
  • Sunscreen/sun block
• Do not bring:
  • Cigarettes or alcohol
  • Tight clothing, short shorts. Shorts should be long.
  • Pierced body parts should not be shown.
  • No Spaghetti straps, tank tops. Shirts should cover the shoulder.

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