a patient still experienced some improvement was 105
days following the injury. Mejía also routinely gives
patients chamber treatments up to five or six times if
they do not improve, while many hyperbaric doctors
stop after one treatment if there is no improvement.
Generally, after the first treatment, the physician has an
idea of how quickly the patient will improve.
To recover strength in his leg, Oscar required eight
treatments, which is unconventionally long. He gingerly
jogged around the clinic in restless impatience — he
had not left the clinic grounds for nine days. Security
plagues the clinic as it does the country, and walking
around the clinic can be unsafe at any time of day.
A hired guard with a shotgun supervises the clinic
entrance after an armed intruder emptied the clinic
cash register at gunpoint. Kidnappings have been an
increasing problem, and a local teenage girl was taken
for ransom during my stay. Now that the wealthy have
employed increased security, the kidnappers have
shifted their focus to middle-class people or the poor
who have the means to borrow money to pay a ransom.
Before Oscar finally left the clinic, he promised us he
would cease diving. If he gets sick again, he probably
won’t recover. Mejía has seen this before: The divers
who have slow recoveries are more likely to succumb
to DCS; if they do, they often do not recover motor
function. “He’ll be back,” Mejía sighed. “Even divers on
the brink of death have returned to diving.”
Job options on the Miskito Coast are severely limited
outside of diving and drug trafficking. Some advocates
push for bans on the local diving industry but provide
no economic alternatives. Mejía is pushing for additional
regulations and safeguards to protect the divers such as
better diving equipment and oxygen tanks for patients to
breathe until they can reach the chamber.
Mejía’s goal for his clinic is to make it self-sustaining,
but its future is uncertain. He has appealed to the
Honduran government for financial help for the clinic;
the government has expressed intermittent willingness to
provide financial support, but it has difficulty maintaining
basic public services. During my stay, the government
had not paid its national hospital employees for six
months, and all services except emergency care had
ceased due to a strike. The clinic spends more than
$3,000 a month in oxygen alone. It continues to run
because Mejía covers many of the costs himself, and his
staff is willing to accept a low salary for the sake of the
vulnerable community they serve.
On my final day in Honduras, I took one last dive in
the crystalline Caribbean waters and again spied a spiny
lobster on the reef. Its species is responsible for an entire
industry and the livelihoods of many of the people I met.
Because Americans crave lobster, Oscar may be able to
send his children to school in hopes of a better future.
By being responsible consumers, we could help
make harvesting lobster a safer job for the Miskito
divers. Americans developed a modestly successful
campaign to buy dolphin-friendly tuna, and
similarly we could demand that our lobster doesn’t
come at such a terrible cost to other people. Small
improvements in equipment and oversight could
significantly reduce the hazards these divers face.
I took my final breaths underwater and watched
my bubbles stream upward. If I surfaced too quickly,
bubbles could cause problems for me. But I knew I had
access to a chamber and, ultimately, medical care in
the United States should I need it. Miskito divers do
not have such certainty. As I left the water, I contrasted
my pleasure with the somber experience of the Miskito
divers who face death with every dive. Mejía and Clinica
La Bendición are more than a blessing for the Miskito
divers: They’re a second chance at life.
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From far left: a lobster boat out of Puerto Lempira,
Honduras; spiny lobster tails in the hold; Dr. Mejía
examines a patient with severe DCS; lobster divers in the
chamber at Clinica La Bendición; a patient undergoes
rehabilitation at Clinica La Bendición; Dr. Elmer Mejía
LEARN MORE
To find out more about diving for lobster in the
Miskito Coast, visit
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ERIC DOUGLAS
ERIC DOUGLAS
ERIC DOUGLAS
