MARCALA, Honduras –
A small boy looked warily at the doctor through teary eyes. He didn't know what the strangers were doing here at his home. He wondered, like many children do, if he would be hurt. He wanted his mother to hold him. The doctor extended the stethoscope to the boy, who slowly reached out and touched it with his tiny hand -- learning at once that no harm would come from this strange equipment.
The scene might have played out in any hospital or clinic, on any day, at any time in the United States. But this time, it was anything but business as usual -- and far from just another day at the office -- for 16 medical doctors, nurse practitioners, dietitians and medical students on a mission in the remote mountains here.
During the two-week exercise, which ended Feb. 7, the team conducted pediatric nutrition evaluations for families without the means or access to regular medical care.
The team included representatives from the U.S. Air Force, U.S. Army, U.S. Navy and South Dakota State University. The wild and primitive duty conditions were a sharp contrast to the traditional medical and academic environments like air conditioned buildings and sanitized exam rooms. The patients here faced health challenges not commonly seen in the United States, and were not used to receiving medical care.
After taking a convoy of tactical vehicles over nearly impassable dirt roadways for more than 45 minutes, the group split into four teams and proceeded to hike into the mountains. The uneven terrain was a constant challenge to navigate, ranging in elevation between 4,000 - 6,000 feet.
"We collect demographic information, immunization history, and provide nutritional training and education," said U.S. Navy Cmdr. Sandra Hearn, a pediatric nurse practitioner assigned to Portsmouth Navy Hospital in Massachusetts. "We also enroll women of childbearing age in the Sprinkles Study for Women, where participants receive small packets of micronutrients to sprinkle in their food daily."
The Sprinkles Study is one of the requests by the Honduran Ministry of Health to determine an acceptable micronutrient supplement containing folic acid and iron specifically for women of child-bearing age, according to Teri Kemmer, a dietitian with South Dakota State University, who has been involved with the study since its inception in 2001.
"During return visits, the U.S. team will report results of the ongoing nutritional study to the Honduran Ministry of Health," Ms. Kemmer said.
Each destination the teams reached provided a sobering glimpse of life in rural Honduras. Large families of six or more children inhabited homes scarcely bigger than a spare bedroom in a typical U.S. household -- and without plumbing or electricity. Small children were initially scared at the sight of uniformed strangers coming to their houses. Their fear quickly turned to curiosity after some tender words of comfort and assurance from Spanish-speaking members of the team.
While some of the medics spoke with parents to educate them on types of locally available food high in iron and nutrients, others examined the children. The otherwise routine manner of care and the banter between provider and patient was interlaced with the barking of puppies and clucking of chickens running around.
In addition to taking height and weight measurements on the children, the medics tested blood samples to screen for anemia. If anemia was detected, iron treatment was provided and follow-up scheduled for when the team returns in four months. The team also dispensed medication to combat parasitic worms to all within the families.
As the sun began to descend toward the mountain ridges, the team of medics packed up their supplies and began the long hike back to the rally point.
Leaving the primitive house on the side of the mountain, the doctor waved goodbye to the little boy now sitting comfortably in his mother's arms. In her hands, she also held nutrients and educational materials that can help make the family's future a little brighter.