Program Philosophy (Why we do things the way we do)
We have partnered with one community to improve the long term health of that community in a sustainable manner. When an individual is sick, we believe curative medicine is essential to offer. However, curative medicine does not improve the health of a community, and is not sustainable for long term community health. Therefore, we work with the community to identify the main contributors to ill health and create interventions to combat the causes of ill health. Many of the causes of ill health are not addressed by curative medicine. This requires stepping beyond our comfort zone and getting into disciplines such as water and sanitation, nutrition, agriculture, banking and education. We attempt to make interventions in a small, low cost manner in an effort to increase long term sustainability from the community perspective. We anticipate sustainable changes will take a generation to realize. The community and our Program do our best to work in a collaborative manner. We are very aware that the Hondurans are very intelligent and hard working. They also better understand their problems than we ever will. We are very cognizant of our many mistakes, but we continue to learn from our mistakes and make small, steady improvements in our interventions. We also accept that communities and their needs/problems change over time, so constant adaptation is required.
If one looks at the time line of the human race, it is only in the last 100-150 years when significant advances in personal health and wealth have occurred for a small percentage of the human population. This 150 years is a tiny spot on the 10,000+ years of humanity. Although we from the developed world like to think of our ways as superior, we have only enjoyed our ease of life for a very brief time. We are not better, just fortunate (possibly) to be born in a country that has advanced a bit faster than less developed countries. Our goal for our work in Honduras is to accelerate the development process to improve health outcomes for all in a sustainable manner. We do not believe our society is the best long term answer for humanity and we hope that through the collaboration of our two cultures, we can find a sustainable solution that is good for the Hondurans and for the planet.
Why we do not have a feeding program or feed local people while we are in Honduras
Feeding programs create dependency. The people being given free food become dependent and at some level, entitled, to free food. It reduces a person’s drive to expand their food production capacity. Our program also becomes dependent on donors to support a feeding program long term. Except in starvation situations, it is much better to help people find methods to increase their own food production and become self sufficient. People in the served communities have been dealing with food security issues for thousands of years. We believe it is much better to invest 20-40 years in improving food security in a sustainable manner that does not breed dependence. If you see a hungry person in front of you when you are here and give them a meal, yes you have helped them for that meal. But there are hundreds of millions of other people around the world who are just as hungry. What happens to that person you fed, when in 2 weeks you are back at home and not giving them free food. They and the millions of others are out there just as hungry, but you can more easily ignore their plight while you are home. Some argue that by giving a handout, you are treating yourself; your own guilt about you having and others not having. Does that help the poor person long term?
We made an exception to this policy during the Covid pandemic. Honduras locked down the country for many months. People were not allowed to travel to other towns. People were not allowed to go out for work. People really struggled to get food and earn money. Working with local community leaders we identified the most vulnerable of the population and delivered food to help them through the worst of the lock down.
Why we charge for medications
Someone has to pay for the medicines. If the Honduran government will not provide medicines, then either donors or the recipients of medicines must pay. We use the revolving drug fund approach to keep costs to a bare minimum that is affordable for most local people. It makes them responsible for the appropriate use of the medicines. It also avoids dependence on outside agencies. This increases long term sustainability. People generally value anything they have to work hard for or pay for, more than free handouts. A number of other agencies have run into financial difficulties because of providing free medicines. We have also found that when medicines are provided for free, the majority of patients presenting to the clinic are not actually sick. They are making up symptoms in order to obtain free medicines. Sometimes this practice has become so bad that dispensed medicines are found in local markets for sale. Another common scenario is when a person states they do not have enough money for a specific medicine (such as an antibiotic), then they pull out additional money to buy soap or shampoo. Infrequently, we will provide essential medicines for a very poor person, but this happens rarely and in collaboration with community members.
We often perceive almost everyone in the project area as very poor – and they are from our reference point. However, when local people are asked to identify the real poor in their communities, they identify 1-2 out of 100 families.