The Heat Is Online

After Mitch, Honduras reels from deadly disease spread

By Richard Chacon, The Boston Globe Dec. 8, 1998

TEGUCIGALPA, Honduras -Six weeks ago, it was the violent winds and torrential rains of Hurricane Mitch that sent millions in this country running for shelter. Then came the grisly task of digging out bodies and the counting of displaced families. Now, this small, impoverished Central American country is battling an array of deadly diseases and infections that could kill as many people, officials say, as the storm itself.

The Honduran government issued a national state of alert Friday because of epidemics following the hurricane. As many as 20,000 cases of cholera have been confirmed, the government says. More than 30,000 people have contracted malaria and 208,000 more have serious cases of diarrhea, which can be fatal for infants and small children. "This is when the real pain begins," said Douglas Ryan, Honduran director for Catholic Relief Services, a private volunteer organization. "From the level of destruction we've seen to water systems and their infrastructure, these kinds of numbers don't surprise me at all."

The government's estimates are dramatically higher than those previously given by health workers and aid agencies. Two weeks ago, for example, the Pan American Health Organization, the leading medical assistance group working in Central America, confirmed a total of about 560 cases of cholera in Honduras, Nicaragua, Belize, El Salvador, and Guatemala, the countries hardest hit by Mitch.

The Honduran Health Ministry also said in its alert that 62 peo-ple had been diagnosed with leptospirosis, a disease spread by rats that can cause liver or kidney failure. Four people so far have died from the disease. In addition, health workers said that 1,080 cases of dengue, a mosquito-borne illness that can cause chills, joint pains, and hemorrhaging, have been confirmed in Honduras. Although some international health and aid workers yesterday raised questions about the accuracy of the govern-ment's figures, no one doubts that this country, roughly the size of Ohio, has become an incubator for life-threatening diseases.

"Public health conditions here were vulnerable even before the hurricane," said Leopoldo Narvaez, a doctor who practices out of his home in a Tegucigalpa neighborhood. "We've been dealing with AIDS and high rates of cancer. But now we're talking about national epidemics to have to fight and with few resources."

Most of the worst cases of cholera, an intestinal disease that can kill through severe dehydration, and malaria have been found along the country's numerous rivers, in rural villages, and along the northern coastal communities, health workers said. But some cases have been reported in the capital city of Tegucigalpa, most-ly in people who live or work near the Choluteca River, which since the storm has become a putrid collection of human waste, animal remains, and rotten food. Near the city's central market, one of the most popular shopping areas for everything from veg-etables to fresh chickens, some residents have begun scavenging the river to collect items that can be washed and resold on the street. Government officials closed the market for health reasons immediately after the storm hit, but the hundreds of vendors sim-ply have relocated their booths across the street.

Unless health workers can control the spread of diseases, the death toll from illnesses could double the 9,000 Central Americans who have been killed by Mitch, the most destructive hurricane to hit the area this century.

In Honduras, the country hit hardest by the storm, the official death toll stands at 5,657. On Friday, however, the country's Justice Ministry said it had suspended the governor of the state of Santa Barbara for overstating the number of dead there. Rather than the 1,159 dead initially reported, the government said, the actual number was 282. The spread of so many diseases has stretched the country's med-ical institutions beyond capacity. Even before the threat of dis-eases appeared, hospitals and clinics were busy treating many of the 12,000 people who were injured by the storm.

Many water systems, most of which were built only recently, were severely damaged by heavy rains or by rivers that in some instances swelled up to 45 feet above their normal level. "More than 60,000 homes have been completely destroyed," said Scott Solberg, deputy director in Honduras for the relief organization CARE. "So much of the basic water infrastructure is still clogged with debris. The magnitude of destruction is astounding."

Officials in other Central American countries also are trying to fight the spread of diseases. In Nicaragua, more than 400 cases of suspected cholera and six of leptospirosis have been reported. Guatemalan officials have confirmed 26 cholera cases, and two have been found in Belize. Many of those who are not ill are being urged to take precautions. Aid organizations have distrib-uted thousands of water purification tablets. Children are being vaccinated for hepatitis and tetanus. Rescue shelters are being checked regularly for infestations of rodents and mosquitoes. And government agencies are warning families to beware contaminated meats and produce.

Amid such grim precautions, many Hondurans are trying to resume their daily life. Along streets once covered with leather-colored water and outside many of the hillside homes that ring the city, Christmas lights and ornaments hang in anticipation of a more peaceful, joyful time. "It's important that people feel a sense of restoring their livelihoods," said Ryan, of Catholic Relief Services. "This has been like waking up from a nightmare."