The first hospital ever built in Garifuna, Honduras is shown in the top photograph. In the middle photograph, life in the rural section of Honduras is depicted. The last photograph shows Dr. Luther Castillo and a Cuban doctor working out of the pharmacy at the Ciriboya Community Hospital. (Toussaint Losier photos)
CIRIBOYA, HONDURAS — Dr. Luther Castillo has much to be proud of. As a young, man, he nearly gave up his dream of becoming a doctor in part because he grew up poor in Garfina.
Yet, he held onto hope, enrolling in Honduras’ main medical school. But he had to drop it. Tuition was just too high.
But a chance encounter got him back on track. In the aftermath of Hurricane Mitch in 1998, he happened to meet several Cuban doctors and learned about their country’s new Latin American School of Medicine. Tuition, accommodation and board are free there for the thousands of international students. The catch, the doctors told him, is that the students, nearly all of whom hail from impoverished communities like his own seaside village, commit to returning home to serve the primary health care needs of the poor and oppressed.
Castillo jumped at the opportunity.
In the five years since graduation, Castillo has worked with other graduates to open the first ever hospital in Ironia municipality and among the Garifuna people.
“We finished in 2005 without any money, but we decided to come here to do something,” explained Castillo, a licensed family physician. “First we cleared out this land and made a little tent and started taking care of patients.”
Within two years, they had completed the construction of the Ciriboya Community Hospital. A small, two-story concrete building, it lies along a dirt road that cuts through this Garifuna village along the Atlantic coast. It is along this coast that the Garifuna, a people of African and indigenous descent, have made their home for hundreds of years.
Prior to its construction, residents of the municipality had to be transported to another town to seek treatment. Today, the community hospital is a valuable asset, with a pharmacy, as well as ultrasound and x-ray equipment. All the hospital’s expenses are paid for through the Luaga Hatuadi Waduhenu Foundation (“For the Health of Our People” in Garifuna).
On Aug. 13, 2008, Castillo and others officially inaugurated it at a ceremony attended by then-President Manuel Zeyela. With government support, the hospital met a range of patient needs, including birthing, surgeries, dental care, laboratory tests and prevention services. It also staffed 11 satellite clinics and organized home visits and other outreach activities throughout the area.
“Our community has subsisted on its natural knowledge of medicine, which has managed to survive from generation to generation,” Castillo noted. “So as doctors we try to integrate those two parts, the part of medicine that we learned in the university, with who we are and our ancestors, which we shouldn’t be divorced from.”
Over the past five years, Castillo estimates that the hospital has attended to 406,000 patients, all at no charge. As a result, infant mortality in the area has declined, from 32 deaths per thousand births to just 11. This is nearly half the current infant mortality rate in Honduras.
“Here we are also creating a small health model of free health care for patients that can be an example in this part of the country,” he explained. “Everybody free, the medicine free.
“This is the first time in history that the women in this area have access to free ultrasounds, free monitors, have their gynecological care free, have their tests for free. For us, it’s an opportunity that doesn’t have a price for our people.”
Resistance and Repression
In recognition of his work, the Zeyela administration named Castillo director of International Cooperation in the Honduran Foreign Ministry in June 2009. Several weeks later, a right-wing coup ousted Zeyela from power. In the days that followed, Castillo was outspoken in denouncing the coup, helping to organize daily demonstrations for Zeyela’s return in the streets of Tegucigalpa, while also attending to the wounded at night.
Word soon spread that his name was on a “hit-list” of those who would be targeted by the defacto government. The OAS Inter-American Commission of Human Rights warned that he was among those whose safety they considered to be “at risk.” While traveling to the U.S. in September 2009 as a national spokesperson against the coup, Castillo found himself unable to return to Honduras for a brief period of time.
The Garifuna hospital also became a target of the defacto government. In the first days of the coup, soldiers raided it, taking medicine and threatening staff. Three months later, 15-armed military police stormed the grounds of the hospital on the pretense of searching for illegal drugs.
As it reversed modest social reforms enacted under Zeyela, the defacto government also moved to downgrade the status of the hospital, threatening to put it under new management. When the staff refused to leave, the government stopped providing medical supplies and eliminated the stipends for the locally trained nurses and Garifuna physicians. Donations to the foundation and the volunteer work of doctors from abroad, including several Cuban doctors, have since helped to keep it functioning.
In the eyes of Castillo, it is the mix of this new ethic of free medicine and traditional Garifuna self-reliance that provoked the heavy-handed response from coup forces.
“In a place where health is commercialized,” notes Castillo, “how rarely we see a system that provides free health care to the most needy and populations that can’t pay for it.”
Castillo and the Garifuna hospital have not been the only targets of political repression. In the year since the coup, human rights violations have increased dramatically, continuing even after November elections brought calls for national reconciliation. This political crisis has helped to fuel a violent crime wave, with more than 5,200 people murdered in 2009, a murder rate double the average in the Americas.
“[Government officials] try to say that there have been no human rights violations because of the silence that they have maintained,” explained Meri Agorcia of the Committee of Family Members of the Disappeared in Honduras (COFADEH in Spanish), an NGO that has investigated the torture and killing of government opponents since the 1980s.
In the first three months of the coup, Agorcia argues, the beatings and killings were broad and indiscriminate, as the military and police lashed out at the mass marches.
But since the elections, the beatings, tortures and murders have become more selective, primarily targeting teachers, peasant leaders, LGBTQ activists and youth organizers in the National Front of Popular Resistance (FNRP). With a backlog of hundreds of cases, COFADEH has already documented 52 instances of political assassination.
Seeking International Recognition
“At first they killed and kidnapped people that were organizing in the different neighborhoods, the ones that were doing consciousness raising work,” explained Agorcia. “Then, they started to attack people that were distributing information about human rights violations.”
“And why? In that moment, [the inauguration of] January 27 forward, they started attacking these people because the new government was trying to get international recognition and one of the obstacles was the violation of human rights. So if [the international community] had more information about human rights violations, there would be less recognition at the international level.”
Recently elected President Porfirio “Pepe” Lobo has sought to break out of the isolation the defacto government faced in the months following the coup. Already, Lobo has won official recognition from the European Union, the United States and several Latin American countries, most recently Mexico. While the U.S. has pushed for Honduras to be readmitted to the Organization of American States, key members, like Venezuela, Brazil and Nicaragua, have held up its return because of ongoing political repression.
While President Barack Obama initially denounced the coup, Agorcia maintained that it would not have been able to happen without the participation of the U.S. Key coup leaders received military training in the U.S. and the Honduran Special Forces have used American military bases to fly individuals out of the country. Agorcia also alleged that during the negotiations between Zeyela and the defacto government, the U.S. appeared to be encouraging some sort of resolution while working behind the scenes to draw out the process.
For Miriam Miranda, president of the Black Fraternal Organization of Honduras (OFRANEH) and a key figure in the FNRP, this repression has also manifested in constant government surveillance.
Twice, officials nearly prevented her from flying out of the country because her name was on a list. She described death threats against her and her family, acknowledging that she has had to change where she lives every four to six months.
“One thing that is very important is that everything needs to be made visible,” Miranda suggested. “If we stay quiet and don’t denounce these things, denounce these actions, don’t denounce what is happening, they are going to destroy us.”
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