I can't comment on Inn of Last Resort, but I can say that Roatan is a great place to stay and dive. In contrast to diver 85's experience, I met a young American that had contracted malaria while on Roatan (his only Central American experience). He had just finished his second bout with it when we met. Whether or not it is common, see your doc and get the meds. Please check with a travel doctor, as my wife and I have had bad experiences with our GP prescribing too much antimalarial pills. If you get chloroquine let me suggest that you take it two days before you travel (it is taken once per week, starting ONE week before travel) so that you can get used to it. We both have some adverse side effects, but they go away after a day.
Will you have transport while you are in Roatan, or will you be staying and diving solely at Inn of Last Resort? If you have a means of transportation, or wish to take a taxi here and there, go to West End! West End is rather small, but the atmosphere is perfect for a deco stop after a day of diving. Enjoy a drink at Sundowners, dinner at the Argentinian Grill (hopefully the new chef has things under control by now), and a few more rounds at the Purple Turtle to finish off the night.
If you're not diving at IoLR, try out Coconut Tree in West End. They run a great operation - good equipment, nice boat, great people. Gay and PJ are the owners and may be some of the nicest people I have ever met while traveling. Tree (yes, that is his full name!) is the manager of the shop and knows Roatan better than many locals. We just got back from our second trip to Roatan (returning for DM/IDC this fall!) and it was Coconut Tree that made us want to come back.
Let me also suggest that you bring lots of small US bills. $1 and $5 bills are great - every place we have been takes dollars, but they give change in Lempiras. If you have small bills you will not need to deal with two currencies very much. Tips are included in the bills at a lot of the local restaraunts, so check your bill before giving additional (and if you really liked your meal or service, tip as you may).
Cash is king in Roatan. A lot of places do not take credit card, and those that do are required to charge tax (16%) for CC transactions. Do not forget to bring cash to cover your departure tax ($32.32 each, if memory serves). Taxis from/to the airport generally run $15, so keep an extra $50 for your last day to cover expenses on your way out of the country.
Aside from diving you might want to buy some coffee while you are there. We stock up big time each trip we make to Latin America. Our favorite coffee is Cafe Copan, but Beunos Dias is also quite good. Pricing is about $4 - $5 per pound ($4.50 / lbs at the airport for Cafe Copan) and we usually buy 10 - 20 lbs each trip.
As for travelers diarrhea - it is quite common. It is often referred to as the "Roatan Runs" or "Getting Roatanned". Be cautious with salad or any fruit or vegetable that does not have an outer skin. Drink bottled water if possible and exercise proper care in selecting food or beverages. If you get it, do not fret too much. Drink lots of sports drink (Gatorade) to keep hydrated and take appropriate antibiotics to kill it off. A decent travel doctor or GP can prescribe you some meds in case you get it.
The language on Roatan is English, so there should be no major language barrier to overcome. Expect to have some difficulty understanding the locals if they start chatting in Patois (Caribbean dialect / permutation of standard English).
Lastly - Roatan is rugged. It is beautiful and full of character, but it is not highly developed and Americanized like many Caribbean islands. Don't be surprised if things go a little askew - this is not Disneyland of course. Relax and enjoy your dives, have a Port Royal or Salva Vida (beer) to finish off the day, and don't stress the little things. Latin America is a different world from the US or Canada, but it is an amazing part of the world worth going back to several times.
I posted a trip report of our recent Roatan trip on this board that has some other tips and opinions. Feel free to read it if you so desire. My wife and I liked Roatan enough that we are going to spend six months there (which involves selling a house and stowing our personal goods)....
