The health of Belizeans varies greatly depending of where they live. Generally speaking, the population of Toledo, being the district furthest from the capital city where most health services are centralized, has the poorest health index. The 2003 WHO poverty assessment report listed the Toledo district with a poverty rate of 79%.  On average, a professional Belizean earns between 400-600 USD/month, but most Belizeans living in rural settings earn less than 100 USD/month. The GNI per capita is 6,740 USD. This is higher than most of other Latin American countries, but the cost of living is very high in Belize, considering that almost all household products need to be imported. Life expectancy at birth is 58/62 (m/f). Most urban households have electricity and running water. It is not abnormal to see an extended family of 10 sharing a single room house. Houses range from simple wooden thatch huts to more elaborate concrete buildings.

Health Care System

The Belizean Health Care System is a free public system, although more so in theory than practice. There are many hidden costs incurred by patients, as almost all diagnostic and lab tests have a fee.  Although some are merely 1-2 USD, others are much more expensive (a CT scan is 800 USD). Consequently, very few patients can access all medical services. Every emergency surgery/treatment is covered by the system, as are required immunizations for children. There is one main hospital in Belize City, where most of the services are situated. There is also a very costly state-of-the-art private hospital in Belize City.  A smaller hospital is found in Dangriga, where minor surgeries occur. There is no rehab center, and only one expensive private therapy clinic in Belize City. Belize does not have medical or rehabilitation schools; therefore very few health professionals are available. Most doctors have either trained in Guatemala, Cuba or the US.

Punta Gorda, in Toledo, has only a very limited hospital that provides out-patient care and in-patient maternity and observation wards.  Access to medical care is a big issue for people living in the Toledo district. Less then 10 percent of the population lives within 3 miles of a medical facility.

According to the World Bank and the World Health Organization’s (WHO) estimates, 27,000 people in Belize are living with some sort of disability. The 2000 Belizean census found approximately 10.9 percent of the population were living with some sort of disability but this number is debatable and believed it to be much higher Belize has few laws protecting the rights of people with disabilities and there is no entity in place charged with protecting these people. As a result, no strategy is set up in case of an emergency for people with disabilities. There are no subsidies available for parents of children with disabilities. Schools must enroll students with disabilities but are not required to provide assistance; therefore most disabled children never reach school. Seventy-five percent of public buildings are not handicap accessible. No system of public transportation is wheelchair accessible. There is no national policy for the employment of people with disabilities, private or governmental. Furthermore, it is a general belief that disabled children are a punishment from the Gods, therefore they are often hidden from view and do not receive treatment. Many families refuse to work with their disabled children because of this taboo.

When I arrived, the therapy program was still very new, and very few things were set up. I was in charge of providing patient care, developing the therapy program, possibly recruiting more volunteer therapists, training a Belizean rehab field worker, as well as developing an international student program. As I later found out, I was also required to raise some funds for the therapy program. It was a very challenging year, considering that I felt that I pretty much had to start from scratch. There were very few resources available, only one other therapist in the district, no equipment to speak of, and of course, no funding. By the time I left, 2 more therapists had been recruited for 1 year, and we had started the student program with our first student in September. On average, we were able to see 30-40 patients per month. Unfortunately, we were still very limited in terms of equipment, and we could not reach the patients living in far off villages due to transportation issues. I feel a great deal has been done, although there is a lot more challenges ahead.