1. Student Engagement Resources Honduras- Honduras Case Study: Gricel Ferrera Healthcare in Honduras Both the quality and access to healthcare in Honduras are directly tied to income levels. In a country ranked 121 out of 187 on the United Nations’ Human Development Index (2011), healthcare is extremely limited for both the urban and rural poor. Since it’s creation in 1959, the National Public Health system (IHHS) in Honduras has been very slow to grow. For a current population of almost 8 million, IHHS has constructed 43 CESAMOS and 27 CESARES in the entire country. CESAMOS are larger, more comprehensive health centers that usually have a full-time physician during working hours and occasionally a dentist; CESARES are smaller health centers that usually have one or two nurses on staff during working hours but with very little medical equipment and/or supplies. Government clinics typically lack sufficient personnel, equipment and medicine. All medicine for these health centers is supplied by the Secretary of Health, however there is a set amount and frequency of medicine allotments regardless of specific geographic or temporal needs and shipments often arrive late when they arrive. In 2011, there was less than 1 hospital bed in the entire country for every 1,000 people, taking all public, private, and NGO hospitals into account. In a country where public healthcare is so limited and the majority of people cannot afford private care, non-governmental organizations (NGOs) like Global Brigades fill a huge need by supplying medical care in the form of mobile clinics (“brigades”) to thousands of people who might otherwise have no regular access.

2. Student Engagement Resources Honduras- Health Case Study: Gricel Ferrera Gricel lives in the community of La Concepción, El Paraiso, Honduras. La Concepción is a small community of 165 homes and 580 people, and fairly isolated from main highways. Gricel’s family runs a small pulperia (a small store) out of their living room. At 15 years old, Gricel is still in school, which is unique in a community where many children are unable to continue education past grade six. At a young age, Gricel was diagnosed with a degenerative disorder in both of her eyes called keratoconus. This condition causes the cornea to become cone- shaped, which leads to distorted vision, such as multiple images of the same object and sensitivity to light. If she does not receive transplants for both of her corneas, it is predicted that Gricel will become completely blind by the time she is 18 years old. Meet Gricel L A C ONCEPCIÓN

3. Student Engagement Resources Honduras- Health Case Study: Gricel Ferrera Background on La Concepcion Though La Concepcion has a rural health center in the community that had been closed and was reopened in March 2010, the clinic has limited resources and the only place Gricel can receive the continuous testing, treatment and contact lenses she needs is in Tegucigalpa, an all day commute by bus. Her family does not own any cars of its own. Socio-economics in La Concepcion The average family income per month is estimated to be 1200 Lempiras, which is approximately L560 (US $29.65) per person. Just one of the treatments Gricel needed cost $2,000. To put that in perspective, it would take Gricel’s family 5 ½ years of saving their entire income to save one eye. Doctors predicted she would be blind within just four years.

4. Student Engagement Resources Honduras- Health Case Study: Gricel Ferrera Global Brigades and Gricel When she was 14, Gricel’s family first got in contact with the Patient Referral team by sending a note about her condition with the Water Brigades team in March 2012 to deliver to the organization. The Referral team then visited Gricel and her family in their home to have a preliminary consultation and to obtain more information regarding her condition. The PR program assists with necessary medical care that falls outside of the scope of brigades and facilitates the entire process of administering this care. The funding for each patient’s care comes from dedicated student groups who wish to help patients they may have met while on their brigade. Previous cases have included patients who needed long-term medication, surgery, or a transplant. The PR team opened a case for Gricel, and good news came to Gricel a lot sooner than anticipated. On May 1 st of 2012, Hospital Santa Lucia received a cornea for another case of ours, which money had already been raised to cover, but this patient decided to not follow through with his surgery. So instead, two days later, Gricel was able to receive a cornea transplant for her left eye. Gricel’s surgery was successful and she was brought back to the hospital during the days following her surgery to receive post-op care and examination.

5. Student Engagement Resources Honduras- Honduras Case Study: Gricel Ferrera Gricel’s Status Now 15, Gricel still needs intracorneal rings in her right eye. The Patient Referral team is working to fundraise money for her case, but without treatment, she will still lose sight in her right eye. Due to budgetary constraint, the Patient Referral team can only have three to four open cases at any time. Without the program, it would have been impossible for Gricel to seek care. Each brigade sees approximately 900 patients who otherwise have little to no access to basic health care. Patient Referral works to fill a further gap with access to more advanced care. If you’d like to know more about the Patient Referral program, contact the Medical Program at MDAdvising@globalbrigades.org.MDAdvising@globalbrigades.org