From One Patient to a Lifeline: Building a Neurology Clinic in Rural Honduras
In 2017, we started small: one patient, one chart, and me, working out of a borrowed office. I had no grand plan to build a large clinic—but once patients began arriving, I couldn’t turn them away.
Today, that small effort has grown into a busy rural neurology and psychiatry clinic—too busy, really. Along the way, we added infrastructure as needs became impossible to ignore: a built-out clinic space, a nurse administrator, a small pharmacy, portable EEG capability, basic labs, two Honduran neurologists and two psychiatrists, and a steady supply of medications.
All services are completely free to patients.
Where We Are — and How We Got Here
Our clinic is located in a rural region, approximately 1 hour and 20 minutes from Tegucigalpa, Honduras’ capital. We operate within a well-run general medical clinic that provides invaluable support. Patients find us primarily through word of mouth, coordination with surrounding clinics, and limited radio outreach.
We are affiliated with SOCIEDAD AMIGOS DE LOS NIÑOS, a remarkable organization that provides essential logistical and operational support.
At this point, we are the second-busiest provider of neurology and psychiatry services in Honduras.
Funding and Sustainability
Because everything is free—doctor visits, EEGs, labs, medications—funding is a constant concern. I raise money continuously and supplement costs personally. Medications alone are brought in by the hundreds of thousands of tablets at a time, typically every three months.
We are actively seeking a partner to help manage the clinic, with the hope of expanding services to include consistent psychotherapy and physical therapy, both of which are extremely limited in Honduras.
New and Expanding Projects
Prenatal Vitamins
We distribute prenatal vitamins to women living in remote mountain regions who have no financial or transportation access to them. To date, we’ve distributed nearly 100,000 vitamins, with a goal of 450,000 or more, targeting at least 30,000 per month.
Telemedicine
Due to ongoing road construction and difficult travel conditions, we are expanding televisits, both from our clinic and from my office in the Chicago area.
Clean Water Filters
We help install water filtration systems in family homes in impoverished mountain areas. Each filter provides clean water for 5–7 years, transforming unsafe water into a reliable source of drinking water.
Training Other Physicians
In November 2024, I gave a webinar to the American Academy of Neurology on building sustainable neurology programs in underserved regions. We hope to spark broader interest in Neurology in Central America and encourage similar initiatives.
Our Goals
Provide free neurologic and psychiatric care, including medications and labs
Teach medical students, residents, and attending physicians
Publish headache treatment guidelines in Spanish
Train neurologists in headache medicine and establish Honduras’ first headache center
Continue upgrading clinic infrastructure
Support other clinicians interested in starting similar programs
Research, Teaching, and Publishing
We recently published a patient survey study in World Neurology, and there is strong potential for further research through the clinic. I’ve published multiple Spanish-language clinical guides and have a 4th edition of my book, Clinical Pearls, coming out in Spanish—copies of which will be distributed free to Honduran physicians.
I also teach neurology residents at the Public Hospital in Tegucigalpa, which is crowded, under-resourced, and full of dedicated clinicians doing the best they can under difficult conditions.
Staff and Daily Operations
We are fortunate to work with four deeply committed young physicians—two neurologists and two psychiatrists—who could earn comparable salaries in the city but choose to serve here. Our nurse administrator is indispensable. We also rely on interpreters and two pharmacy staff members who manage an enormous medication refill volume.
The clinic operates alongside a small 24/7 emergency department that handles everything from strokes to status epilepticus with limited equipment.
Practicing Medicine in Honduras
Clinical care here is refreshingly direct: doctor and patient, minimal paperwork, no insurance barriers, and very little bureaucracy. Charts are simple. Multiple physicians often follow the same patient, and we emphasize continuity and future planning.
Cultural differences matter. Patients are stoic, family bonds are strong, psychotherapy carries stigma, and side effects are often underreported unless severe. Despite enormous challenges, families care for one another with remarkable devotion.
Why Patients Come Back
Our published survey revealed something unexpected: free medications were not the primary reason patients returned. More important were the relationships, the diagnoses, and being taken seriously.
That—more than anything—is what sustains this clinic.
Looking Ahead
We hope to:
Reestablish psychotherapy services
Expand physical therapy access
Open a dedicated headache clinic in Tegucigalpa
Continue vitamin and clean water programs
Find a long-term partner to help sustain and eventually lead the clinic
If you’re interested in learning more or supporting this work, I can be reached at
lrobb98@icloud.com
— Larry Robbins, M.D.