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Inspired by a Tiny Island, A Doctor Turns to Psychiatry

Demand for mental health services far outweighs available doctors in Honduras, and the island of Roatan, 40 miles off the coast, was even more removed from psychiatric services. Dr. Zeni Duarte is working to fill that gap, one patient at a time.

Dr. Zeni Duarte  meets with a patient in her office on Roatan, an island off the coast of Honduras. A lack of mental health professionals 
 in the country was a driving force for her entry into the field of psychiatry. (Courtesy photo)
Dr. Zeni Duarte meets with a patient in her office on Roatan, an island off the coast of Honduras. A lack of mental health professionals in the country was a driving force for her entry into the field of psychiatry. (Courtesy photo)

When Dr. Zeni Duarte arrived on Roatan – an island off the coast of Honduras – there were no mental health services available. She set out to change that.

“Psychiatry [is] the specialty that sees patients as a whole human, in a more integral and complex way,” Dr. Duarte said.

Nonetheless, health is still stigmatized in many countries, especially  in those where this branch of medicine is relatively young.  Honduras is one of them.

During a four-year stint as a general practitioner on Roatan, Dr. Duarte saw many patients with symptoms related to emotional issues, psychological conflicts, and lack of peer, familial, or professional support. These were people who needed mental health care, but she could not refer them to anyone on the island because there was no psychological or psychiatric care there at time, and there were very few psychiatrists on the mainland..

“I finally said, ‘This is it. This is what I want. This is what I can be doing for the rest of my life without feeling tired, bored, or overwhelmed,’” Dr. Duarte said. In 2007, she left the island to begin her studies on a psychiatric specialty.

Dr. Duarte currently works as the assistant director and psychiatrist at Hospital Psiquiátrico Santa Rosita on the mainland, one of the two largest and best-known mental health hospitals in Honduras, along with Hospital Psiquiátrico Mario Mendoza.

These two mental health hospitals treat the majority of the mental health cases in the country. There are multi-specialty hospitals in Honduras that offer some mental health services, but these services are limited and do not serve the number of patients, or treat the variety of conditions, that Mario Mendoza and Santa Rosita psychiatric hospitals do.

Traveling to one of these two hospitals presents some geographical challenges. The sub-director of Hospital Psiquiátrico Mario Mendoza, Dr. Mario Aguilar, explained  that the limited access to mental health services in other parts of the country lead most mental health patients to travel to Santa Rosita and Mario Mendoza to receive the care and medications they need. Some travel from as far as Roatan, which requires about an 11-hour trip by ferry and bus.

The Mario Mendoza hospital staff accommodate some of the patients who travel the farthest. Instead of having to travel through the dangerous streets of Tegucigalpa at night, they are allowed to stay overnight and sleep on the benches, patios, and other open areas within the fenced walls of the facility.

Even more unfortunate is that it is not uncommon for patients to arrive at the two hospitals to find out that the medications they need are not in stock, a consequence of the structural and institutional challenges of the country’s health care system.

Dr. Duarte continues to dedicate some of her time to serve the patients on the island that originally inspired her to pursue psychiatry. She travels to Roatan once a month to collaborate with Clínica Esperanza, a clinic that serves the island’s underprivileged and that inaugurated a new mental health specialty this year.

Despite Clínica Esperanza and Dr. Duarte’s efforts, and despite an increase in psychologists and psychiatrists on the island, Dr. Duarte believes that more needs to be done.

“Even when now there are more psychologists on the island, and there are a few psychiatrists that are visiting…on the island, there is still a great need to have a special integral center for mental health,” she said.

Since 2009, Direct Relief has donated over $30 million dollars of mental health medications to Honduras. Direct Relief continues to collaborate with local partner NGOs to fill some of the mental health service gaps in the country.

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