Honduras has the highest murder rate in Central America, and people living on the streets of the capital city Tegucigalpa are especially vulnerable to violence.  In an Médecins Sans Frontières survey carried out in 2010, almost 59 per cent of homeless people under the age of 18 reported having been subjected to physical violence in the last year, and 45 per cent claimed to have suffered sexual violence.

People living on the streets are therefore in particular need of medical and psychological care. Often, however, health centres in the city deny treatment to homeless people because of a perceived security threat.

From 2005 to 2010, Médecins Sans Frontières staff operated a centre providing medical treatment for people under the age of 24 who were living on the streets. Staff gave medical and social support to 460 young people over five years. Patients most often required treatment for respiratory diseases, skin infections and injuries resulting from violence. The centre also provided a space where visitors could wash, eat and try to recover from the effects of drug abuse. Patients received psychological support, which helped some to move on and find work or a place to live.

A change in approach

In 2010 Médecins Sans Frontières undertook an evaluation of the services it was providing to homeless people in Tegucigalpa, and decided that a new approach would meet the people’s needs more effectively. The centre was closed at the end of August and a team has begun preparing for a new progamme. This will provide broader services to all age groups in a larger geographic area. Instead of expecting people to visit a centre, our staff will go out on to the street and actively reach out to vulnerable groups living in the most deprived areas of the capital. This approach should enable Médecins Sans Frontières to assist more people and to respond better to the full range of their needs.

Dengue outbreak

An alarming increase in cases of dengue fever in mid-2010 prompted Médecins Sans Frontières to offer support to local health services’ response in the capital, where the majority of cases were reported. Dengue is a viral disease transmitted by mosquitoes. Symptoms are similar to flu, and its most severe form, haemorrhagic dengue, causes bleeding and can lead to irreversible shock and death.

Between August and September, our teams provided medical care, vector control – controlling the means of transmission of the disease – and community education. Staff set up an emergency paediatric ward in San Felipe hospital, where 163 children received treated. Mobile teams also worked to identify and eliminate sources of infection in the Manchen settlement, on the outskirts of Tegucigalpa. Staff travelled from house to house to raise awareness of how to stop the mosquitoes breeding and spreading the virus. The teams also fumigated some 1,600 households and donated more than 400 mosquito nets to hospitals.

Médecins Sans Frontières has worked in Honduras since 1988.