What is poverty?

April 30, 2015
Students (l to r) Lauren O'Neill, Alexandra D'Angelo and Rachele Degraff meet with a family outside their home in San Francisco, Honduras

By Lauren O’Neil '16, School of Nursing

This blog entry has been reposted from Exploring Medicine – Honduras 2015 with the author’s permission. Lauren was part of a team of 14 nursing and medical students who recently traveled to Las Mercedes, Honduras, with DGHI professor Dennis Clements and three other faculty leaders, to provide basic healthcare to about 450 local residents. The trip was part of an ongoing effort to provide Duke nursing and medical students with hands-on experience in global health while improving access to healthcare in rural areas of Honduras.

“The test of our progress is not whether we add more to the abundance of those who have much; it is whether we provide enough for those who have too little.” – Franklin D. Roosevelt

Honduras is the second poorest country in Central America. Over half of the people who live here live in poverty. But what is poverty? What does it look like? The people in Las Mercedes and San Francisco had clothes, they had basic shelter, they had water and food—they even smiled and looked happy. Is this the face of poverty? 

According the World Health Organization (2015), "Poverty is associated with the undermining of a range of key human attributes, including health. The poor are exposed to greater personal and environmental health risks, are less well nourished, have less information and are less able to access health care; they thus have a higher risk of illness and disability. Conversely, illness can reduce household savings, lower learning ability, reduce productivity, and lead to a diminished quality of life, thereby perpetuating or even increasing poverty." 

So how were these villages affected by poverty? For one, they lack access to healthcare. Hospitals and local clinics are short on supplies and medications. One patient we had seen couldn't even have a simple surgery done to fix his hand after a machete injury. He lost the use of three out of five fingers of his dominant hand after severing his tendons. The hospital sent him to a medical supply shop to buy medical equipment for his own surgery, which he could not afford. Luckily, we found a group of hand surgeons coming to the country who can do his surgery for free. However, if this were not the case, he would have to relearn to use his machete with his left hand so that he could continue to work to support his family. Health care issues like this affect their lives every day. Injuries and illnesses affect their ability to work, resulting in decreased productivity, lower income and poorer quality of life. 

A second problem is the quality of water. The water in these areas is not purified. It contains amoebas and parasites that can make people very ill if they do not boil it before drinking. The soil also harbors parasites that infect the children who play in it. These parasitic and amoebic infections cause dehydration, malnutrition, abdominal pain, diarrhea and multiple other problems. Everyone in the villages here must be dewormed because parasitic infections are so prevalent. 

Malnutrition has long been an issue in these villages. They simply do not have access to a fully balanced diet. This results in short stature, bloated bellies, fatigue, impaired immune systems, etc. We saw girls whose hair color was almost blonde as a result of malnutrition.  

Their homes are also extremely small. Families sleep on the same bed. Bedrooms are sectioned off by hanging pieces of tarp. They also have stoves in the house without chimneys to keep smoke from filling the room. This causes respiratory issues for those constantly inhaling smoke from cooking. Thankfully, because of financial support from those who have donated money to our trip, these stoves have all been replaced and everyone in the village will now have chimneys. 

Transportation is also very difficult. Cars are not common in these villages. Buses are loaded with people, some hanging off of the sides just to get a ride into town. Some kids will walk for hours just to be able to go to school. They often cannot afford school supplies or textbooks.

Although access to the many things we take for granted in the United States are not available for these people, they are always smiling. They are very grateful for what is given to them. They are also grateful for what they have. They are a tight knit community. They work together, go to church together, play together and eat together. They are very shy people. When we would see them as patients, they had a difficult time making eye contact and kids would nervously giggle. Little ones often cried. They are very respectful people. They are conservative. They dress in their Sunday best to greet us and to come in to the clinic. They serve wholeheartedly. 

This trip made us question a lot about ourselves and our character. Do I have the determination like these kids to get up every morning to walk two hours to go to school? Would I walk for hours to go to church? Designer clothes, computers, air conditioners, heaters, cars, my own bed—all are luxuries we don't think twice about. We live comfortable lives and it is easy to become lazy. Seeing the way they live their lives makes you reevaluate what is important. I've been so grateful for this experience. We all came back with a new found gratitude for the blessings we have as Americans and for the lessons we learned from the people in Honduras. 

WHO. (2015). Poverty. Retrieved from World Health Organization website.