Sarah, a nurse from the USA, is working for MSF/ Doctors Without Borders in Honduras. She has been focusing on the response to sexual and gender-based violence, aiming to improve treatment and follow up, as well as links with existing services.
Tonight I handed out condoms to commercial sex workers outside a strip club connected to a ‘hotel’ and spent the evening strolling through crowded market stalls with a small team of doctors, nurses and psychologists.We provided medical referrals, performed basic wound care and attempted to talk with a group of young boys, age 5-18 who were under the influence of ‘Glue’.
They congregated around us like the adhesive they were sniffing, hungry for interaction and human touch. This was perhaps one of the most tragic things I have encountered. The streets are full of children, who for a variety of reasons are without a home, the majority of whom are without even a simple blanket to cover their thin limbs. What made this different from my past experiences working with street youth was the fact that every child we encountered had a makeshift ‘vessel’ such as an empty plastic Pepsi bottle or a Coke can tucked inside their shirt.
Each boy would reach inside his shirt every 2 to 3 minutes, pull out the bottle, and inhale. Inside their given receptacles was Resistol; a substance made from the sweet smelling solvent, Toluene which is found in a variety of easily attainable adhesives. This chemical, found in the glue they sniff, is a neurotoxin known to cause irreparable nerve damage. In Honduras, this remains the drug of choice for children. In fact, sniffing glue has become so common that street children are often referred to as “Resistoleros”.
Resistol © Edu Ponces / RUIDO Photo
Boys as young as four years old were high as a kite. One young boy was completely hysterical and begged that we not leave him. He kept repeating “I can’t live without my mom!, why did she have to die!?” “I can’t live, I can’t, I can’t”, and yet here he sat on a sidewalk, with vacant eyes and slurred speech; eyes that were unable to recognize their own surroundings.
Imagine trying to provide counseling to someone so completely drugged by the liquid hidden under their shirts that they are unable to decipher left from right. This boy was still young. He still had time to escape. Others however, can be found sliding their backsides along gutters, sidewalks and city roads, no longer able to feel their legs. Toluene destroys the layers of fat, which surround nerves, thus causing them to die. While occasional inhalation will cause nosebleeds and rashes, long-term use leads to severe neurological dysfunction, brain and muscle atrophy, leukemia, loss of sight, liver and kidney functions and eventual death.
© Edu Ponces / RUIDO Photo
After spending more than an hour with this young boy we finally had to leave. My heart broke a bit inside upon leaving this little boy who was obviously hurting deeply, and yet I also knew that there was very little we could do for him. While we can bring a heart back to life through resuscitation, to repair a profoundly wounded heart and to bring a child back from the influence of drugs is much more complicated. Our valiant and persistent street team returned to the market the next day in search of this young boy as they had found a shelter where he could stay. However, as is the case with those who live on the streets, they are never to be found in the same place and as happens so often, this young boy was lost.
Prior to coming to Honduras I had thought that I would be spending the majority of my time on these ‘Recorridos’ (outreaches), going from ‘point’ to ‘point’ with the street team, searching for those who are in need of care.
After arriving, it soon became clear that my job would look quite differently.
While I was initially disappointed with this change in job description, I am also acutely aware of the myriad of challenges we face in providing care for a population which so desperately needs care, however often lacks the ability to follow up and remain adherent with their medications or appointments. Setting these challenges aside, it is apparent that the street population is more likely to seek care at a health center or hospital if the current services being offered are strengthened.
Outreach © Edu Ponces / RUIDO Photo
This is where we are focusing our work, and there is much work to be done! Thank you MSF for forcing me to take a mandatory vacation next month! I think I am going to need a little R&R.