National Nurses United

forced to train parents on the spot to give a majority of the care. In the pediatric orthopedics ward, most of the young patients were recovering not from the clumsy acrobatics that so often put me in casts as a child, but from bullet wounds. Any supplies that patients needed—from aspirin to bandages to surgical equipment—had to be purchased by family members outside the hospital. But often the private security guards would not allow family members back into the hospital once they had left. Or they would demand a hefty bribe. Honduran nursing students, like their counterparts in the United States, see nursing as a calling. They too dream of providing care to patients and helping them live healthier lives without regard for wealth, skin color, or ethnicity. But although primary healthcare is taught at the UNAH nursing school, as recommended by the World Health Organization, it is only theoretical. As my students discov- ered to their dismay, preventive healthcare is nearly impossible to implement when everything depends on money. As in the United States, Honduran healthcare is defined by money. Privatization has left public hospitals without supplies and most Hondurans have no good options for care when they or their family mem- bers fall ill. The owners of pharmaceuti- cal corporations get rich while the majority of people don't have enough money to buy even the most basic med- ications. In the direly underfunded pub- lic hospital system, patients suffer the effects of (often fatally) lengthy wait times, severe understaffing, and the lack of even the most basic equipment. Mean- while, Honduran private clinics and hos- pitals are exclusive by nature; only those who can pay have access to care, and pri- vate medical insurance does little to ame- liorate the situation. I t is easy to become disillusioned working under such a repressive and deprived system. But though my Hon- duran nursing students had never heard about or even imagined it, there exists a very different model conceived of and established right there in their own country: a place where the application of a primary healthcare model has resulted in a dramatic regional decrease in mor- tality and morbidity in the past decade. It is a place where a community has come together in a successful struggle to pro- vide healthcare as a human right. This place is the First Garifuna Hospi- tal in the small coastal community of Ciri- boya, Honduras. In less than a decade, the nurses and doctors of the First Gari- funa Hospital have carried out more than half a million patient visits. Although the community lacks electric power, with its solar panels the hospital powers an x-ray machine, an ultrasound, dental equip- ment, and a full laboratory. The pharmacy is well stocked with neces- sary medications. The hospital's medical personnel, themselves members of the Afro-indigenous Garifuna ethnic group, are assisted by a permanent rotating brigade of Cuban doctors, nurses, and den- tists. Together, they provide services to a population that—due to a combination of geographic isolation and historical structural racism—had never previously had access to quality healthcare. And they do all this without charging the patient a cent. The First Garifuna Hospital is a community project that directly challenges the entire structure of healthcare in Honduras—or any system premised on the idea of making profit off of providing healthcare. Literally built, governed, and operated by communities surrounding the hospital, it is mainly funded by Garifuna living around the world, U.S. unions and solidarity groups, and the gov- ernment of Cuba, which has trained all the doctors who work there. It is precisely because this hospital challenges the corporate model of healthcare that it has been targeted by successive Honduran governments following the 2009 coup. On Oct. 6, 2009, the hospital D E C E M B E R 2 0 1 4 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 17 As part of their visit to First Garifuna Hospital, a free, community-based primary care center, Honduran nursing students helped staff the pharmacy.

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