By Hemali Bedi
Honduras has had one of the highest rates of urban violence in the world since 2010.  With an average of one violent death per hour in 2013, rates of lethal violence exceed those in many war-affected countries.  As well as having humanitarian implications, the violence in Honduras also presents a critical public health problem.
Seema Biswas, Editor in Chief of BMJ Case Reports, discusses her experience of being deployed as a British Red Cross surgeon working with the International Committee of the Red Cross (ICRC) in Honduras in a new article published in the Guardian.
Seema Biswas comments: “Local doctors and nurses keep working. They are well organised, well informed, resourceful and committed to dealing with the continuous emergency of an overburdened health service. They are not silent, but they are considerate in their thoughts and measured in their comments. They explain the situation to me: there are complex problems here. The most vulnerable are the poor. To address their health, communities need to be safe and they need access to education and employment that pays a regular salary sufficient to feed their families.” 
Many factors are thought to contribute to the growing violence in Honduras, including political instability, corruption, inequality, organised crime and gang related activity.  Universal strategies to reduce violence in Latin America are featured in the United Nations’ 2030 Agenda for Sustainable Development . The top 10 recommendations to improve safety in Latin America are: 
1. Align national efforts to reduce crime and violence, based on existing experiences and lessons learned.
2. Prevent crime and violence, promoting inclusive, fair and equitable.
3. Reduce impunity by strengthening security and justice institutions while respecting human rights.
4. Generate public policies oriented to protect the people most affected by violence and crime.
5. Promote the active participation of society, especially in local communities, to build citizen security.
6. Increase real opportunities of human development for young people.
7. Comprehensively address and prevent gender violence within the home and in public environments.
8. Actively safeguard the rights of victims.
9. Regulate and reduce “triggers” of crime such as alcohol, drugs and firearms, from a comprehensive, public health perspective.
10. Strengthen mechanisms of coordination and assessment of international cooperation.
What are your thoughts? For more information about global health and the social determinants of health, browse through our global health case reports, which focus the causes of ill health and access to healthcare services in all parts of the world.
 OSAC. Honduras 2016 Crime & Safety Report. https://www.osac.gov/pages/ContentReportDetails.aspx?cid=19281, published online March 2013
 B-Lajoie M, et al. The need for data in the world’s most violent country Bulletin of the World Health Organization 2014;92:698. doi:http://dx.doi.org/10.2471/BLT.14.136713 http://www.who.int/bulletin/volumes/92/10/14-136713/en/
 Biswas S. Field post: ‘Honduras has one of the world’s highest rates of urban violence’. https://www.theguardian.com/global-development-professionals-network/2016/jul/27/honduras-urban-violence-hospitals-highest-rates#comments, published online 27 July 2016
 United Nations Development Programme (UNDP) (2013) Citizen security with a human face: evidence and proposals for Latin America. Human development report for Latin America. UNDP, New York. http://hdr.undp.org/sites/default/files/citizen_security_with_a_human_face_-executivesummary.pdf, published 2013