Honduran Coop Sets Ambitious Health Initiatives
In Honduras even basic socio-economic development is a struggle for the local communities and official health and poverty indicators for rural communities are among the lowest in the Western Hemisphere. But from eradicating infant mortality to women’s health and dealing nwith depression, the Capucas cooperative is showing the world of coffee just how far ambitious new initiateves in health can achieve for the community’s 5,000 people.
It’s a regular day of the week just after nine in the morning and already over 10 people are waiting outside the health clinic in the Capucas coffee cooperative in Western Honduras. While this might be a normal sight in many parts of the world, this is a highly unusual scenario for not only a coffee town in Honduras, but for a coffee-growing community in most parts of the developing world. For visitors who make it up to the steep coffee mountains here (between 1,400 and 1,600 meters altitude) it’s hard not to be excited about the activities unfolding on this freezing day in early February where temperatures reached just 6 degrees Celsius at dawn. In Honduras, health coverage has yet to be a top priority for the cash strapped government that is trying to address multiple major challenges from endemic poverty to rampant gang violence. But at Capucas in the coffee region of Santa Rosa de Copan local efforts show just how far a little extra attention goes. “I am waiting for the doctor because I have had a this cough for a really long time now and want to check if perhaps he can give me some medicine,” said Maria, a female grower in her mid-50s who identifies herself by only her first name, adding, “Before we had a doctor here we would get used to live with these kind of symptoms but now most of my family and neighbors have told me how they have been able to cure this kind of cough.”
Inside, a handful of mothers are sitting with babies and young children, waiting to be seen. In some cases it’s only to receive information about the next campaign of vaccination of basic diseases such as polio, but in other cases the doctor will check for early signs of more dangerous illness like bronchitis or pneumonia, diseases which even in many urban areas of Central America can be fatal as they often go undiagnosed and untreated.
“A lot of the people here live at altitudes of 1,500 meters or even higher so it’s not surprising that most of the issues affecting people are respiratory issues from common sore throat to bronchitis and pneumonia from the cold and humid weather,” Dr. Radamez Fuentes told the Tea & Coffee Trade Journal during a recent visit.
“When I first came here three years ago I noticed a lot of issues with a lack of attention to pregnant women, children with chronic respiratory problems, hypertension, cardiac issues and diabetes, but in that time, since the clinic has had a permanent doctor, there has been no maternal mortality and not a single child under one year of age has died,” said Dr. Fuentes.
It’s no small miracle for a doctor in rural Honduras to be able to report such progress in health indicators for a community as those which currently are unfolding at Capucas, also known as the COCAFCAL coffee cooperative. Overall rates in Honduras for infant mortality remain among the highest in Latin America with an average 17 deaths per 1,000 children under one year of age between 2011 and 2015, and only slowly coming down from 20 by the end of year 2000, according to figures by the Washington, D.C.-based World Bank. Maternal mortality in Honduras, meanwhile, was registered at 129 per 100,000 live births by the end of 2015 compared to 149 by the end of 2000, World Bank figures show.
“Many of the families in our communities had to travel up to 15 kilometers on rural roads to get proper medial attention so the idea of hiring a doctor came up at one of our meetings and the results have been very positive,” said Omar Rodriguez, the general manager of Capucas. The coop’s over 800 members produce eight different labels of certified coffee including organic, Fairtrade, UTZ and Rainforest Alliance on 3,500 hectares of land. “Having a doctor at the clinic has had a major impact on the community because with people being able to get a professional attending their health needs, not only have we been able to establish a much more precise diagnosis of the heath issues affecting our people but we have also been able to start preventing more severe cases of disease such as diabetes and pneumonia,” said Rodriguez.
From Vision to Reality
The results from what started as an ambitious vision to take the health coverage to a higher level in the community are fascinating from more than just the social perspective of what kind of health issues coffee growers deal with on a daily basis. After three years, Capucas has become a rare case study providing completely new insight into both common and more surprising nhealth issues affecting coffee communities on a daily basis.
“There has always been a nurse and while a nurse obviously can help attend to a lot of basis health issues, by having a fully-trained doctor, we have been able to diagnose what the most prevalent issues are in the community when it comes to health,” said Dr. Fuentes. He said that depression is the fourth most common cause among the health issues affecting the people, after respiratory diseases, hypertension and diabetes. “Many people come with a lot of anxiety because they worry over what to do if they don’t have a good harvest or if prices are low. When this situation prevails for a longer time it ndevelops into depression but these are the kind of symptoms a nurse is not trained to diagnose and all these issues from diabetes to depression are issues we can provide treatment for,” he said.
It has long been an official standard in the world of coffee that cooperatives and larger farms offer growers and workers in the community the services of a health clinic as dictated by legal requirements by most governments. Many clinics struggle to have even a nurse attending on a regular basis, because many health care professionals opt to rather work in areas closer to urban areas, finding a community with a permanent doctor is rare.
With statistics at hand, Capucas’ manager Rodriguez is now getting ready to launch the latest initiative in health coverage for the community with a team of “medical brigades” specialized in dental care soon starting to fan out across the 12 villages and communities covered by the cooperative in the region with the capacity to attend up to 1,000 people.
“Today we have actual statistics that allow us to plan ahead for activities needed in the future and because the doctor’s salary is paid by the cooperative, and not the government, we are also able to request specific attention to other or more issues when needed,” said Rodriguez. A fourth-generation farmer himself and the great grandson of the producer who first started growing coffee in the Capucas region in the 1880s, Rodriguez adds, “Having a doctor has shown us why it’s not enough to only get the attention of a nurse and we are excited about moving ahead with more social projects in health.