October 23, 2013

Médecins Sans Frontières (MSF) teams are battling to save children’s lives as a deadly outbreak of dengue hemorrhagic fever sweeps through Honduras’ second-largest city, San Pedro Sula.Children are especially susceptible to the mosquito-borne disease. Three out of every four patients MSF treats at the public hospital in the northeast of Honduras are under 15, and there are three times as many cases as last year.“Since we started to work here, we’ve seen a constant flow of patients,” said MSF medical coordinator Dr. Luis Neira.Overwhelmed health authoritiesIn August 2013, the number of suspected cases of dengue hemorrhagic fever reported in the region was up 235 percent on the previous year. Local health authorities were overwhelmed, prompting MSF to launch its response.“I came from Azacualpa, four hours’ drive away, as my granddaughter was sick,” said Mariana. “She had been sick for a few days, but the local health centre couldn’t treat her.”Mariana’s granddaughter, who has dengue with medical complications, was transferred to the intensive care unit set up by the MSF team in the Mario Catarino Rivas public hospital in San Pedro Sula.Deadly viral diseaseThe health centre El Carrizal is one the four health centres supported by MSF in Tegucigalpa.Endemic in Central America, dengue is a viral disease spread by mosquitoes, with symptoms like those of flu.However, this relatively mild form of the disease can develop into dengue hemorrhagic fever, which can cause bleeding, irreversible shock and sometimes death.In Honduras, there are four different types of dengue virus. “The four types circulate,” said Dr. Neira, “with the risks of infection particularly high during the rainy season, from May to November, when the mosquito responsible for spreading the disease proliferates.”There is no specific treatment for dengue fever, but early diagnosis and appropriate care can drastically decrease the death rate. However, getting diagnosed and treated in time can be a challenge, as healthcare in Honduras is in a state of crisis, with medical supplies and qualified staff in short supply.“The problem is that many people face multiple barriers in accessing timely and adequate treatment,” said Dr. Neira.Dengue unitsAn MSF team has trained medical staff in health centres around the city of San Pedro Sula to detect cases of dengue early and to refer sufferers to hospital promptly, while also ensuring that all children under 15 are able to access medication and treatment, free of charge, at the Mario Catarino Rivas public hospital.The team has set up a dengue unit in three of the hospital’s children’s wards, with MSF medical staff supporting and training hospital health staff.In the two months since starting work there, the MSF team has treated more than 560 children in the hospital’s emergency unit, one quarter of them under the age of five.“We’ve also donated drugs and medical supplies to the hospital for the treatment of adults affected by dengue,” said Dr. Neira. MSF in HondurasAs well as its emergency response to the dengue epidemic, MSF works in the Honduran capital, Tegucigalpa, addressing the medical consequences of violence in some of the city’s most violent neighbourhoods.MSF has been working in Central America for more than 25 years, responding to natural disasters, emergencies and other medical and humanitarian crises.