The Atlantida General Hospital is the main public government-run hospital serving the city of La Ceiba and its suburbs (population 300 000). It is a two-storey, 120 bed, level I facility with a general emergency department, departments of paediatrics, obstetrics and gynaecology, neonatal medicine, internal medicine, and general surgery, and an operating and recovery room. The hospital campus also houses a pharmacy, paediatric immunization clinic and a large outpatient clinic. The hurricane had badly exacerbated the already severe shortages in medical staff, equipment and drugs. Access roads were blocked and supply lines cut. There was no potable/running water as a result of damage to the water and sewage systems, and electricity failures occurred at frequent intervals. The destruction of the entire second floor of the hospital had caused serious overcrowding. In addition, the Honduran army was evacuating patients by helicopter from isolated rural areas to the hospital. The emergency department was very deficient in oxygen and advanced life support equipment, and used sheets for stretchers or beds were being replaced with brown paper.
The permanent staff of the Atlantida Hospital consists of only three paediatricians, two general surgeons, and one or two specialists in internal medicine. There are no physicians trained in emergency medicine, and even under normal circumstances, there is no emergency department director. The work in the emergency department is carried out primarily by interns (eighth year students on an obligatory rotational service) and family physicians. The permanent staff works from 07:00?h to 13:00?h and continues thereafter on an on-call basis only.
