Indigenous Tolupan communities who live in the mountains of Yoro have to walk for hours to access basic health services, a debt owed to them by the State. When they arrive at the welfare center, no matter what ails them, there’s only acetaminophen available.
Text: Allan Bu
Photography: Amílcar Izaguirre
Translated by: José Rivera
Karla Patricia Soto woke up at 4 am on Saturday, April 29. She and her three sons had a long trip ahead of them, they walked through the unpaved roads that outline the side of the mountains in the department of Yoro, in northern Honduras. Karla lives in a village called El Palmar, but that day she had to walk for two hours to Piedra Gorda, where a medical brigade arrived with the support of the Valle de Sula Rotary Club. For Karla, her family, and her neighbors, this was a unique opportunity to see a general practitioner, a dentist, and a gynecologist.
That day, hundreds of people, just like Karla, went to the medical brigade to get medicine and to see a dentist. Eighty percent of patients who went to the brigade were Tolupan, yet another indigenous community abandoned by the State whose duty is to defend their rights and protect their culture.
Access to health services is one of the countless needs Tolupan tribes have. They are located in six municipalities in Yoro and two in Francisco Morazán. Karla Patricia belongs to a tribe located in a region called Locomapa, in the department of Yoro.
On the day the brigade arrived, more than 1,200 patients, including adults and children, were seen by a doctor. Many patients had to sit for five hours on an old bus to get to the center where around 20 medical professionals saw Karla and hundreds of others from indigenous communities. Some patients walked for five hours to what they considered one of the few opportunities they will ever have to see a doctor and get medicine.
«I have pain in my body and my colon, I also have headaches and other diseases», said Karla when asked what made her seek medical attention so far from home. She added that «thanks to God and the brigade» she can get medicine for herself and her three children who accompany her.
One of the volunteer doctors from the brigade said that most people who come are not ill, at least at the moment they are seen by a doctor. Communities have been abandoned by every single administration, and the brigades are an opportunity to take preventive measures against diseases, «only 15% of patients are sick», said the doctor.
On other occasions, Karla had to walk for up to three hours looking for medical attention and has gone back home with nothing. «It’s tough when you have to travel that far and not get any medicine, at times we have gone back home empty-handed. It’s very difficult to get an appointment at the health center, and, you know, we come from afar, but thank God we got enough medicine today», she said.
She also mentioned that after walking or paying 175 lempiras to a driver to take her to the health center in the village of Ocotal, she was denied medical attention because she was late. They don’t take into account the fact that it takes up to three hours to get to the health center and there’s no public transportation, «the first thing they say is “if you’re late you won’t get an appointment” and doctors see patients who live nearby first and those who come from afar are seen last, and we are late because it’s a long journey».
One day, Karla went to the health center with her son who was badly injured, but he was denied medical attention because they arrived at 11 am and the nurse said it was too late. They told her she could visit the hospital in Yoro, the administrative center, but it’s a five-hour drive from her house because there’s no public transportation along the entire route. A roundtrip by bus costs 160 lempiras, but only two buses leave each day and those who make the trip might have to spend the night in Yoro or somewhere else. Karla told them she doesn’t have any money and that’s why she came to the health center, «I don’t have money, I’m poor, but I should publicly denounce you so people know how you behave», said Karla to the nurses. She went home with her son and had to rely on home remedies to treat him.
During Xiomara Castro’s administration, doctors have complained about the shortage of medication in hospitals and have demanded an increase in supply. Health Minister, José Manuel Mateu, assured in an interview for Televicentro that some hospitals have been stocked up to 70%. He also talked about plans to build eight hospitals before a new government was elected. None of those hospitals will be built in Yoro since there already are three regional hospitals in El Progreso, Olanchito, and Yoro, the administrative center, which is the closest one to the Tolupan tribes.
The government’s position is inconsistent because they announced the construction of hospitals while in early May, medical staff from Hospital del Tórax, where pulmonary diseases are treated, protested due to a lack of supplies and medication. Suyapa de Sosa, a doctor, said to the media that they’re using sanitary pads instead of cotton and that’s the reason medical staff called a strike. This takes place just a few minutes away from the centers of power such as the Presidential House or National Congress, in the same city where the Health Minister and the President live. It’s reasonable to deduce that the lack of health services in the mountain where Karla Patricia lives, which can be reached after a three-hour drive on an unpaved road and where there is one health center helping more than 20 communities, is more precarious than in the capital.
«In the health center, you’re lucky if they have medication because, as you know, everyone has different health issues. I mostly suffer from stinging pain in my head, and when I go to the center and explain to them that I’m in pain, they just give me acetaminophen», said Karla.
Karla Patricia and other people we talked to agreed that a few months ago it wasn’t that bad, there was a «special» doctor, one of those committed to helping others, who would see Karla and her children and wouldn’t «discriminate». In Locomapa, you see the darker side of Honduras, the doctor had his bike stolen from him which he needed to go to work every day. He got his bike back, but medical attention in the village of El Ocotal hasn’t been the same. Sometimes he would set up an improvised practice in Piedra Gorda where he saw up to 180 patients on a single
Don José is almost 70 years old. We saw him walk up a slope as he leaned on a piece of wood. He can barely move his fingers and his skin has withered. He’s diabetic and went out to get medicine. His mother was Tolupan and his father Ladino, «that’s why I’m taller», he said, meaning taller than the average Tolupan. He lives in Piedra Gorda.
A medical brigade like the one organized on Saturday, April 29 is a good opportunity to get medicine because in the health center, which is 40 minutes away from Don José’s house, they only offered him acetaminophen. He saw on one occasion medical personnel throwing away medicine that had expired. He thought about filing a complaint but he didn’t. His complaint would have probably been forgotten among the countless debts this administration and all previous ones owe to the Tolupan.
At the age of 67, Romelia Romero walked for about three hours from the village of Mezcales, where she lives, all the way to Piedra Gorda, where the Rotary Club medical brigade came to see patients. She told the doctors that she suffers from at least four medical conditions for which she got medication.
That day she got medicine for headaches and back pain which she has every now and then. On other occasions, she has walked for four hours and gone back home without any medicine. Romelia also goes to the health center in the village of El Ocotal, and even though she has obtained some medicine, she has had to pay 15 lempiras for an appointment, which is too much for a 67-year-old who lives alone in a remote village in the mountains of Yoro. «You can get medicine, but you have to pay. Once, I had to pay 15 lempiras for an appointment and then I paid for transportation on my way back home», said Romelia.
Doña Romelia is among the 74% of Hondurans who live in poverty. Due to her condition, she only has access to basic health and education services granted by a corrupt and incompetent State that has done just the minimum to address those needs.
Merary Soto, not a relative of Karla Patricia, is a Tolupan leader from the village of Piedra Gorda. She told us that besides the lack of health services, most Tolupan don’t own decent housing, and sadly, in this country, it’s a problem that doesn’t only affect indigenous communities. According to a 2020 study carried out by Habitat for Humanity, Honduras is in need of 522,076 new homes and 844,000 were in urgent need of remodeling. That study was carried out before hurricanes Eta and Iota, which destroyed almost 10,000 homes, according to official data.
Employment is yet another challenge for the Tolupan people. In El Ocotal, Piedra Gorda, Mezcales, and other nearby communities, men earn 150 lempiras for a day of work growing and harvesting corn and beans to provide the basics for their families. Merary also noticed there’s a serious alcohol addiction problem among men and besides food, «they also buy half a liter of sugar-cane liquor and they bring the rest to their family».
Coffee harvest season is an opportunity to earn money, but it only lasts three months and, according to Merary, the cycle continues, many spend part of their wages on alcohol, which leads to frequent domestic abuse. «I don’t know what it’s like to be physically abused, but in some households, the father doesn’t bring food and gets drunk and physically abuses his relatives».
Gender violence is an issue that has its roots in the idiosyncrasy of a patriarchal and dogmatic country, and these are problems the Tolupan people can’t get away from, communities who have far more problems than not getting medical attention in a health center where only acetaminophen is handed out.
1.A group of indigenous women and children start their journey back home. They walked for three hours between the mountains from the community of Chagüite to Piedra Gorda in the region of Locomapa, Yoro, looking for medical attention. CC/Amilcar Izaguirre
2. The Tolupan people live in eight municipalities, six in the department of Yoro and two in the department of Francisco Morazán. There are approximately 20,000 Tolupan in 28 tribes. Three tribes are located in the mountain of La Flor, where the native language of the Tolupan, Tol, is still spoken. The San Juan tribe is located in Orica and was under the leadership of Chief Cirpiano Martínez until his death in 2015. Former president Manuel Zelaya gave a donkey, known as Palmerolo, to Martínez in 2009. CC/Amilcar Izaguirre
3. In Locomapa, there are around 23 communities. Those with the largest population are Mezcales and Cabeza de Vaca II where around 60 families live. They travel to the health center in El Ocotal to get medical attention and where they are seen by a nurse. Some villagers have to walk through pathways for four hours to get to the health center. CC/Amilcar Izaguirre
4. Rotary International has arranged the arrival of medical brigades for indigenous communities for many years. Volunteers join the brigade and in addition to seeing patients, they bring food and share it with the Tolupan people in the community of Piedra Gorda in the region of Locomapa, Yoro. CC/Amilcar Izaguirre
5. The Locomapa River flows across indigenous communities in Locomapa, Yoro. During summer, the water level decreases. Along the route between Yoro and these communities, the landscape is dry and looks like a desert. You can notice fields have been burned. CC/Amilcar Izaguirre
6. Four Tolupan children have lunch on a tree trunk in front of the Piedra Gorda catholic church in Locomapa. The Tolupan settled in the mountains of Yoro and Francisco Morazán. CC/Amilcar Izaguirre
7. Yearly medical brigades by Rotary International provide assistance to the Tolupan of Piedra Gorda. It’s an opportunity to see a medical practitioner and a dentist. CC/Amilcar Izaguirre