Health a Victim in Mitch’s Wake

This crowded mountain capital is pocked with the scars of tropical storm Mitch. There are the spindly, mud-caked skeletons of once-bustling shops. There are the dirt stripes slashing the green hills, neighborhoods ripped away.

Yet for Albertina Ponce, a seamstress, the most frightening scars are the ones that appeared on her 3-year-old daughter, Gisela, who blossomed with red, pus-filled sores the size of raspberries.

“Everything is contaminated here,” said Ponce, watching the grave, dark-haired girl play along the San Jose River in front of their home.

Glancing at a smashed sewer line spewing yellowish waste into the river, the mother grimaced.

“I’m very worried there could be an epidemic,” she said.

Four months after Mitch struck, killing at least 9,000 people, Central America faces a nightmarish challenge: restoring shattered health, water and sanitation systems before illness sweeps the population.

It is a gargantuan task. One out of three hospitals and clinics in the region was damaged, according to the Pan American Health Organization, a United Nations group. Nearly all rural aqueducts were ruptured in Honduras, the hardest-hit country. Hundreds of thousands of people lost their running water.

But the focus of authorities’ fear is the collapse of sanitation, illustrated by swirling cesspools such as the San Jose, one of several rivers in this city of nearly 1 million. With the Central American dry season beginning, the level of the dirty water will drop, creating breeding grounds for flies and rats.

Mitch could claim still more victims, authorities say, unless help arrives soon.

“Since the pipes broke all along the rivers, sewage is falling freely into the water,” acknowledged Umberto Jesus Puerto, director of Honduras’ water authority. “This is a latent source of disease.”

The health system in Central America was struggling even before Mitch struck. Crumbling hospitals, infectious diseases and cities crisscrossed with open sewer channels were common.

The region, however, had made striking progress in recent years. Governments had expanded their immunization programs, increased access to clean water and attacked infectious diseases. Infant mortality plunged, from 65 per 1,000 babies in the early 1980s to 36 today.

The question now is whether the countries will lose their hard-won advances.

So far, governments have averted the epidemics some feared after Mitch.

Experts credit authorities with mobilizing quickly to prevent widespread outbreaks of cholera and other diseases.

In Honduras, for example, brigades of medical students fanned out into communities, chlorinating water supplies. U.S. soldiers and relief workers rushed to join Honduran medical teams in inoculating children.

Doctors worked tirelessly even as some were becoming refugees themselves. Keilyn Rodriguez, for example, fled Morolica, about 60 miles by road southeast of Tegucigalpa, just before it was wiped out by flood waters. She became the sole doctor in a nearby tent camp, treating up to 70 patients a day suffering from parasites, strep throat and diarrhea.

Rodriguez, 25, could have fled. But, she said simply, “my parents are here, and I need to work.”

Meanwhile, throughout the country, Honduran technicians struggled valiantly to hook up a water system crippled by silted-in pumps, contaminated wells and pipes that folded like giant drinking straws. The majority of Tegucigalpa residents now have running water again, and rural aqueducts have been patched up.

But huge problems loom.

Much of the water system is functioning thanks to slapdash repairs, experts say. And emergency health aid is running out--just when the government must step up efforts to attack disease-carrying insects and monitor outbreaks, said Dr. Jose Antonio Pages, local representative of the Pan American Health Organization.

“The government doesn’t have money to keep these programs going,” he said.

For Honduran authorities, the biggest worry is rivers such as the San Jose that empty into the Choluteca, a waterway that divides the crowded capital. At one time, pipes dumped city sewage downstream. No more.

Cesar Augusto Lopez Flores, a senior Honduran sanitation engineer, stood on a bluff overlooking the San Jose one recent day, calculating the disaster that could occur.

Below him, it looked as though a giant claw had scooped up the earth around the quiet river, smashing the surrounding stone walls, snapping sewage pipes and turning the narrow banks into an expanse of muddy puddles and dirt piles wider than a football field.

“Most of this is sewage--probably 70%,” said the stocky engineer, gazing down at the trickling brown river.

“In summer, the situation will be more critical because the water just sits,” he said. “Epidemics could begin. It’s urgent we drain this.”

His fears were echoed on the opposite bank. There, Albertina Ponce quietly watched her 8- and 10-year-old sons help their unemployed father dig mud from the river, heaving it into piles to sell to builders.

The barefoot boys cheerfully plunged ankle-deep into the fetid water. On the riverbank, Gisela played with her cousin, a toddler with 15 red sores dotting her legs and arms.

“The dirt is contaminated, and the kids play in it,” shrugged the 33-year-old Ponce.

She tried to keep them clean, but the energetic children wound up in the water and the feces-laced dirt, she said. Forget about keeping them inside; her in-laws’ tiny home, where the family moved, now housed 15 people.

Ponce was worried. Gisela had fevers as well as sores. And, like most local children, the two boys had gotten bronchitis, probably from breathing the dust whipped off the waste-filled mud. The local health clinic, however, had run out of children’s cold medicine.

Authorities say fixing the sewer system is particularly daunting because of the huge cost--about $120 million nationwide. The U.S., Japan and several European countries have donated money and technical help to repair the Honduran drinking-water system. However, few governments pay for pricey sewers.

This renovation is part of a giant health and water repair bill from Mitch. Honduran Health Ministry officials put it at $300 million--three times their entire annual budget. Nicaragua will need $80 million to restore its systems.

Major aid for reconstruction is not expected to start flowing until after a meeting of potential donor countries being organized for May by the Inter-American Development Bank and other groups.

Meanwhile, in health clinics across Central America, doctors and nurses are struggling with damaged equipment, shortages of medicine and streams of patients with colds, diarrhea and rashes.

In Honduras, four of the country’s 29 public hospitals will have to be replaced completely, Health Minister Marco Antonio Rosa said. The storm damaged 123 of the nation’s 1,100 clinics.

“There are health clinics that don’t even have thermometers,” Assistant Health Minister Elliethe Giron said. She had flown by helicopter with a team of government doctors one recent day to the destroyed town of Morolica, now a mass of tents.

Rodriguez, the refugee doctor, had made a heroic effort among the people from Morolica. Yet, as the visiting doctors took their places behind desks in the open air, it was clear that the townspeople’s needs were overwhelming. A long line formed of coughing children, worried mothers and frail elderly people.

Evelia Lopez, a 22-year-old mother in a Trump Plaza T-shirt, clutched the youngest of her four children. The baby had been born a month earlier in a tent.

“She doesn’t sleep, day or night,” Lopez sighed.

Yes, Lopez said, she was able to get medicine, clean water, food. The basics. But, asked how big the infant was, she shook her head. In these times, a baby scale is a luxury.

“I haven’t weighed her since she was born,” she said.

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

How to Help

Monetary donations are being accepted by these Los Angeles groups to help transport supplies to Central America and provide other aid to victims of tropical storm Mitch:

* United Way: Make checks out to United Way, Help Central America, 523 W. 6th St., Los Angeles, CA 90014.

* The Consulate of Nicaragua: Make checks out to Nicaraguan Consulate Hurricane Mitch Transportation Fund, 3303 W. Wilshire Blvd., Suite 410, Los Angeles, CA 90010.

* ASOSAL, the Assn. of Salvadorans: The organization is accepting donations for hurricane relief aid in El Salvador, Guatemala, Nicaragua and Honduras. Make checks out to Central American Relief Fund, 660 S. Bonnie Brae St., Los Angeles, CA 90057.