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Honduras
I will be providing information on Honduras, which is one of the poorest countries in the western hemisphere. I have had the chance to witness first-hand how poor the country is, and how little the people there have. In both 2015 and 2016, I had the privilege to spend a week there, working with a surgical team in a hospital to do procedures for people free of charge. They ranged from relatively simple hernia repairs and cholecystectomies to more advanced things like moving the esophagus and removal of large tumors. Honduras seemed to rank around the 125-130 mark for most of the information I found.
The country has a population of just over 8 million, with about half residing in urban areas (WHO, 2017). They also ranked around that area for infant mortality, which was 17.7%, and literacy rate runs around 89% (Factbook, n.d.), which surprisingly ranks it as 149th, well below half of the other countries in the world. Life expectancy averaged 71.1 years, broken down to 69.5 years for males and 72.8 years for women (WHO, 2017). Surprisingly, 93% of the population are subscribers of cell phone service (U.N., 2016). Healthy life expectancy at birth was 64.9 years, slightly lower than average life expectancy. Cause of death registration coverage was very low at 17%. Many of the people in the country work either in some type of agricultural setting or working to make textiles. Knit sweaters and knit t-shirts both account for about 12% of exports. Coffee came in at the same percentage. Banana exports are about 4% of total exports, and sadly the major money from that is not kept in-country.
The companies that own the plantations and factories do not have an interest in the country and send the money elsewhere. Insulated wire is another large export with 9% of the exports from that. 1.9% of exports are created from rolled tobacco, mostly cigars (OEC, n.d.). As a cigar aficionado, I believe they produce fine tobacco there. Textile scraps, narrow woven fabric, undergarments, melons and other fruit, fish, vehicle parts, soap, gold, and petroleum each hold less than 2% each of export totals. All are important to the economy of the country. The country ranks very low in many health-related areas. For example, the cause of death registration coverage does not seem very high.
One of the patients I dealt with in the hospital had been in a motorcycle accident and had a severe closed head injury. He eventually died, but they continued to manually ventilate him until his heart stopped on its own. His heart rate fluctuated for many hours due to the swelling in his head, but I am unsure how they documented his death, whether it be cardiac arrest or a vehicle accident. There is little to no tracking of patients in a hospital, and there are many risks associated with that. Patients do not wear identification and their charts are stacked at the nurse's desk. Documentation is all done on paper, which can be misread or even get lost. Access to healthcare is limited to those who can afford it, and I would not say they have much of a public health system. While nurses, physicians, and other healthcare providers are highly educated, many citizens that work other jobs do not have the need or luxury for obtaining further education.
There is an obvious gap between those who have money and those who do not. There is not much of a middle-class, as we have here in the United States. While the country has improved slightly over the past decade, it is still far from being a developed country. Nearby countries like Belize and Costa Rica offer tourism, which can draw in money to improve conditions. Unfortunately, the biggest draw for Honduras tourism is the island of Roatan. This does not provide much income to the country. Hopefully, the trend of improvement will continue for years to come, and increase the level of health in the country.
