
After a Fire, Three Hospitals are being Built on the Island
Roatan has found itself in a health crisis. On April 19, around 9pm, Roatan Public Hospital in Coxen Hole burned down in a spectacular fire. The fire destroyed 95% of the 33 year old building except for a portion of the office annex.
No one was killed or gravely injured in the fire and 60 interned patients were transferred to two nearby private island hospitals. Wood Medical Center in Coxen Hole received most of the patients and the private Hospital Centro Medico Sampedrano (CEMESA) received another dozen. “All the emergencies were attended until May 10 [for] free,” said Dr. Jackie Wood, owner of the Wood Medical Center who also helped to build the original public hospital in 1991. “My heart was broken and I cried all night. You do not imagine what I feel to see all that work [turn to] ashes.”
The firemen concluded that faulty electric wiring was the reason for the fire. “A couple years back we had a fire in a maternity room for the same reason,” said Dr. Wood.
The spring of 2024 has been full of fires breaking out all over Roatan. There has been very little rain since the rainy season ended on the island in March. Dry as bone trees and cohunes became prone to catching fire and strong winds made things especially difficult to handle.
While the fire was a disaster, it also became an opportunity to quickly and efficiently upgrade the islands hospital facilities. While the public hospital building was gone there were plenty of doctors, underutilized private clinics, a network of community clinics, a semi finished hospital in Dixon Cove, and there was an 18,000 square foot Adventist center.
Instead of quickly finishing the new public hospital in Dixon Cove, the central government decided to build a “temporary” hospital in Coxen Hole. Instead of using facilities that are available, the government set up tents in hot weather at Julio Galindo stadium in Coxen Hole.
“My heart was broken and I cried all night.”
Another site in Loma Linda area of Coxen Hole was chosen by the central government as a site for an emergency, provisional 40 bed hospital and is estimated to cost 100-150 Million Lps. It has been planned to be finished in 90 days, but due to a complicated, heavily sloped site, that is unlikely to happen.
The Loma Linda hospital site is adorned with a huge poster “Xiomara Sí Cumple,” – “Xiomara does deliver.” In fact after the fire and presidential visit the island was dotted with “Xiomara Sí Cumple” signs. There is one such poster at the Roatan international airport, one in Dixon Cove, one in Loma Linda and one at Coxen Hole stadium. A kilometer away, while central government authorities were erecting those signs, Roatan Municipality completely demolished the burned out hospital and practically flattened the old hospital site.
All in all, the facility that was closest to being able to function as a temporary hospital was the Adventist center in French Harbour. Little Friends Foundation along with Roatan Municipality operated the COVID center at the Adventist center back in 2020. While the second story of the large building was used for consultations and beds, the first story is being readied to function as an emergency center for the emergency temporary hospital before the provisional hospital is finished and before the new hospital in Dixon Cove is completed.
Six weeks after the fire things are far for clear for many islanders in need of medical attention and confusion still persisted. “The ambulances take you from the street and don’t even know where to take you,” said Steven Guillen, president of Little Friends Foundation, a NGO that was in charge of building the Dixon Cove hospital facility. “If you are dying, you have to go to CEMESA.”
In May a woman in labor was asked for money from treatment at Woods Medical Center, she didn’t have the funds, so she was transferred to CEMESA designated as an emergency care center. The transport she was using broke down and she was transferred to another vehicle. By the time she arrived at CEMESA it was too late and she died.
That could have been avoided. The Adventist center was ready to operate two weeks after the hospital fire. The current construction work on the hospital is being paid by the Roatan Municipality and donations. There is a blood testing center for TB and HIV being built as well.
For the time being, nurses and doctors are allocated to several centers around the island. While Roatan Municipality is financially and technically capable of building, even equipping a public hospital, it does not feel capable of running the hospital with accredited and paid staff – that is a step too far.
The history of the 20,000 square foot Roatan Public hospital goes back to 1991. According to Dr. Jackie Wood, it cost the government $7 million to build. It could have been much more, but many good willed people helped it along. “Equipment was donated from the United Kingdom government (…) donations from Roatan people and private companies from Roatan and La Ceiba and the central government,” said Dr. Wood.
The island outgrew the medical facility within a couple decades, but the road to the new public hospital has had been fret with hopes, mistakes, delays, and wishful thinking.
In 2006, after 15 years of the Roatan Hospital serving the public, then Mayor Dale Jackson decided that it was time to build a new hospital. Land in Dixon Cove was purchased as “an emergency purchase.” Eighteen years later that emergency still hasn’t been resolved.
The one million dollar land cost paid was an extremely high cost for the municipality. It took the next administration of Mayor Julio Galindo to pay off the purchase completely. There was nothing done during the Mayor Dorn Ebanks tenure.
While the fire was a disaster, it also became an opportunity.
When Jerry Hynds became mayor in 2018, he was able to secure a $2 million donation from Kelcy Warren, US billionaire and owner of RECO, for the construction of the hospital in Dixon Cove. “When the funds ran out the Municipality started using some of their own funds to complete the gray work. “The original discussions were that the Municipality would do the gray work and they would finish the hospital,” says Guillen. Windows, doors, some of the sewage and water infrastructure was also finished. Roatan municipality spent $500,000 and within a couple of years there was a large, 75,000 square foot two story building sitting on a hill in Dixon Cove.
In Honduras many things are accomplished when local and central government belong to the same political party, that was not the case with National Party in Tegus and Liberal party on Roatan. “ [Mayor] Jerry [Hynds] said: ‘If they [central government] are not going to join, we are going to finish it,” said Guillen. “He had it in his mind that he was going to finish it one way or another.”
In fact the construction of the new public hospital was a joint effort and not only Kelcy Warren’s donation and municipal tax dollars funded it. “May people donated freight, equipment time and helped to reduce costs,” said Guillen. While these donations were not enumerated by Little Friends Foundation, they likely run into hundreds of thousands of dollars.
In 2022 the 75,000 square foot Dixon Cove hospital building has been finished in raw state with windows and doors placed. The building sits on 8.3 acres site and there is a basement. Electric, sewer and gas lines could be installed as per requirement.
“There were verbal agreements, but never any written agreements with any administration,” said Guillen. Several visits by central government contracted engineers and architects took place. Recommendations were made, fulfilled, but nothing was put on paper and signed. “Every time the central government sent a crew of engineers they came up with a list of changes. Moving and creating walls, doors,” said Guillen.
The reality was that Roatan’s politicians were working with best intentions in a constantly evolving political climate back in Tegucigalpa. “The idea was to pass the facility into the hands of the Honduran health ministry in a raw state, and for them to finish it up to their standards,” said Guillen. According to Guillen the land title has been transferred to the national government years ago.
After Ximara Castro’s Libre Party won the national elections in November 2021 the relationship between Roatan Municipality and José Manuel Matheu, Honduran Health Minister under President Xiomara Castro, was going well. “We had a very good relationship with him. He brought in IDB [International Development Bank],” said Guillen. That all ended when in December 2023 Matheu was replaced with Carlos Aguilar. Since nothing was written down and agreed, Municipality was left holding the bag.
After the public hospital burned down a political turf war for credit as far as who is building what with whom’s money on Roatan intensified. It seems that Honduran president’s Libre Party was not willing to give credit to local authorities who are affiliated with the Liberal Party.
Then there was the bigger issue. If the new Roatan hospital was to be finishing with locally done contractors and donated equipment there would no way for big players to make money and make themselves seem indispensable. If local authorities would solve their own infrastructure and health problems, like Roatan has attempted, there would be no need for dependency on international loan institutions. That would mean 2000 bankers and bureaucrats in IDB Washington DC headquarters would lose their salaries, and that cannot be.
According to Honduran authorities $47 million dollars is now needed to finish the new hospital and equip it. The around $2.5 million spent on the building by Warren and Municipality is a rounding error of the estimated remaining costs. Now plenty of companies will have an opportunity to skim off the very high top and make money in the bonanza.
Roatan Municipality is financially and technically capable of building, even equipping a public hospital.
Local authorities say, that the building could be finished and equipped and ready to open for a fraction of that sum. “We could get all the equipment in very good condition donated,” said Guillen.
That is unlikely to happen. Since 2010 IDB has allocated 35% of its annual loan approval to “small and vulnerable” members and Honduras is qualified as one of them. IDB constantly needs new projects to allocate millions, and tens of millions of loans. Finding donors for a new public hospital is good business for IDB and good for its bottom line.
For average islanders worried about their health, the money, the funding and technical matters are too complicated to contemplate. Yet, the fact is there is money to be made loaning out money. There is plenty of money to be made in the construction of a new hospital and plenty of entities are eyeing the Roatan project.
It is the central government that decides what the municipalities need, often with a faulty understanding of population dynamics and local idiosyncrasies. This is how Roatan Island ended up with a Coxen Hole desalination plant and José Santos Guardiola with a garbage dump in Punta Blanca that never opened. These white elephants were paid from loans and grants by IDF and Inter American Development Bank. These projects are expensive and justify the existence of large international lending institutions.
The sad part is not only about the debt that is unnecessarily created, it is also that Honduras does need government investment in other parts of the country and is not getting it. One such example is the rebuilding of Canal Maya (In the Sula Valley, Mainland Honduras) that was destroyed in the 2020 Hurricane season, yet there are no funds and no one to rebuild it.
Other than IDB, another winner in this situation and all this chaos could be CEMESA. They have secured an agreement with government for treatment of patients. What is not known is how much CEMESA charges the government for these services. CEMESA prices are high, an appendix surgery can cost Lps.50,000 or more.
After the fire, a fund was set up out of which CEMESA is paid by Ministry of Health and Ministry of Finances. “CEMESA don’t have 11 million Lps. This in an insurance fund,” said Doctor Lastenia Cruz, Roatan Hospital Director, on May 29. “We are in front of CEMESA, we are meeting them constantly.”
There is a great contrast with how government and private business deal with a fire, and efficient restructuring. For example Waldina’s Tapestry shop, a private business that burned to the ground in French Harbour in February 29, 2024. With very few resources, but with much motivation, the owner was able to rebuild and reopen her upholstery and sail repair business within weeks of the fire. A great contrast to the paralysis and confusion of the central government after the Roatan hospital fire.
At the end of June there was no agreement what to call the French Harbour Adventist hospital facility. Some islanders still call it the Adventist Center, some call it Adventist Hospital, and some still call it the COVID Center.
Still the Adventist Center has been receiving plenty of non emergency patients. On May 27, Aldin Ebanks, a patient from Coxen Hole, went to Wood Clinic in Coxen Hole where he was told to go CEMESA. At CEMESA he was told to go to the Adventist center. All this took time, money, and transport expense. He was diagnosed with water in his lungs, and treated at the Adventist Center.
Roatan’s politicians were working with best intentions in a constantly evolving political climate.
The Adventist center is now open 24 hours a day and the number of specialists working at the Adventist center has been gradually increasing. “The Adventist center opening will cover all the services required by the population,” said Guillen. “They have greater capacity than the original public hospital.”
There is a plan to use both the downstairs and upstairs of the Adventist Center. The Municipal is making plans to turn the two story building into a fully functional hospital. The facility is actually larger than the original public hospital in Coxen Hole.“We are trying to centralize everything here,” said Guillen.
While the Adventist organization is letting the Honduran ministry of health use the facility without a written contract. Again, this could lead to misunderstandings and conflicts. Who pays for electricity costs, for maintenance costs, or for damages is not 100% clear. “They [central government] should work with the Municipality to set up this [Adventist Center],” said Guillen. “We don’t know how long they will be on temporary basis.”
Some consultation services were decentralized from the public hospital to community clinics outside of big towns. The recently opened clinic in Flowers Bay is picking up plenty of work.
The island’s medical situation will clear itself out in a matter of a year, or two. There is one question that remains and that is whether perhaps the central government and some international organizations, despite what they say and want you to believe, are not there to help you in the most sensible and efficient way, but to exploit your problems to the advantage on interest groups.
Many of us agree to pretend that police, health, education and emigration services are here to help. We are afraid to admit how inefficient, malevolent and expensive these government entities are. The cost of realizing that would be we would have to do something about it. It is easier just to go on pretending.
$47 million dollars is now needed to finish the new hospital.