Mark Wilson gives you some tips on arranging your elective in Honduras

Despite being one of the world's biggest banana exporters, Honduras, as this month's elective reports show, is poor. Honduras has been independent from Spain since 1821, but military dictatorships prevented democracy until 1984. Natural disasters--including Hurricane Mitch--have also contributed to Honduras's problems.

Honduras spans Central America and has some beautiful virtually uninhabited coasts and a mountainous interior. Knowledge of Spanish is essential, but the experience makes the effort worthwhile.

Medicine

The healthcare system is by no means comprehensive: only two thirds of the population live in areas with access to hospitals and clinics. Infectious diseases are rampant. Malaria, cholera, dengue fever (which has had severe outbreaks recently), and visceral leishmaniasis are common, and everything from infective diarrhoea to Venezuelan equine encephalitis occur. There is only one doctor per 2000 people. HIV prevalance varies from area to area, but the national average is estimated to be 2%.

Visa and work permits

British citizens do not need a visa if staying for less than 90 days. If you are not a British citizen contact The Embassy of Honduras, 115 Gloucester Place, London W1H 3PJ (tel +44 (0)20 7486 4880; fax +44 (0)20 7 486 4550). Another useful address is The Ministry of Health, 3 Calle, 4 Avenida Tegucigalpa MDC, Honduras (tel 222 8518; fax: 238 4141; www.paho-who.hn/ssalud.htm).

Universidad Nacional Autónom de Honduras, Edificio "Hernán Corrales Padilla" Calle de La Salud Contiguo al Hospital Escuela, Tegucigalpa (tel 232 3975; fax 232 1053; www.unah.hn) is the only medical school in Honduras, and you are probably better off applying for electives directly through individual hospitals.

Hospitals

Finding information about hospitals in Honduras has become much easier with the advent of the internet. A fantastic site is www.projecthonduras.com. A subweb of this (www.projecthonduras.com/ healthcareproviders) lists hospitals, contact email addresses, and even "wish lists" of equipment needed for many hospitals, some of which are quite remote. Some charities--including the Lions Club of San Pedro--can provide information on hospitals in need.

Main hospitals

• Hospital General San Felipe, Boulevard San Felipe, Avenida Los Prceres, Tegucigalpa, MDC, Honduras (tel 336 7698)
• Hospital Leonard Martinez, 9-10 Avenida, 7 Calle, SO No 56, San Pedro Sula, Honduras (tel 550 8415)

Some small hospitals and clinics

• Hospital Suizo Hondureño, La Ceiba, Atlántida (tel 441 2029 or 441 0069), is a small 30 bed hospital
• Hospital Evangelico, Siguatepeque, Comayagua (tel 773 0170)
• Clinica Materna de Corquín, Corquín, Comayagua
• Hospital Divina Providencia de Corquín, Corquín, Comayagua
• Clinica de Ojos Fraternidad, San Pedro Sula, Sula Cortés (tel 553 0631)
• Hospital del Area, Puerto Cortés, is a medium sized hospital with 72 beds
• Clinica Esperanza y Vida, Colonia Las Brisas Danli, El Pariaso, (tel 883 2347)
• Hospital Gabriela Alvarado, Danlí (see Jenny Hall's elective report on p 24)
• Centro de Cancer Emma Romero de Callejas, Tegucigalpa DC, Francisco Morazán (tel 231 0813)
• Clinica Solidaridad y Vida, Tegucigalpa DC, Francisco Morazán, is a small hospital with 10 beds and a clinic
• Hospital Adventista, Valle de Angeles, Francisco Morazán, is a 65 bed hospital
• Instituto Nacional Cardiopulmonar, Colonia Lara, Boulevard de los Proceres Tegucigalpa DC, Francisco Morazán, is the country's national heart and lung hospital
• Centro Medico Bayan, Palacios Gracias a Diós, is a small hospital in a remote village of 700 people
• Friends Hospital, Rus Rus, Gracias a Diós, is a more remote hospital with 32 beds

Diving medicine

If it's diving medicine you're after, there's a recompression chamber at Anthony's Key Resort, Hyperbaric Chamber Roatan, Bay Island (tel 45 1049; fax 45 1049).

Your health

Polio, typhoid, tetanus, and hepatitis A and B immunisations should all be up to date and prophylaxis for malaria is needed in many areas. See your occupational health department for regional advice.