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Introduction: In April 2002, 13 volunteers traveled to El Salvador to participate in a medical brigade, bringing medicine, consultations, and other treatments to the rural poor. I accompanied this brigade in the role of 'journalist', to take pictures and record events as they unfolded, and to then share them with PeaceHealth and our communities through Crossroads and the Internet.
El Salvador is a country of many contrasting emotions -- beauty, tragedy,
warmth, devastation, relationships, violence, humor, families, and politics.
I will attempt to describe this range of experience in the series of
writings to follow. This is the first article in this series. It is rather long--longer, I suspect, than future installments will be. But it is important to understand a few basics about the country of El Salvador to appreciate the context of the PazSalud mission. |
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Day 1 & 2 --
Travel and Orientation, the Picture Not Taken.
Our flight out of Seattle began bright and early by getting to the
airport at 6:00 a.m., where we were promptly greeted by three angels
carrying Krispy Kreme donuts and orange juice!
Sisters Sheila, Beth, and Catherine were there from Bellevue to bid us
farewell. Our flight into and out of Houston, and into San Salvador,
went just like clock-work -- all luggage and supplies arrived without
incident. Descending into San Salvador was quite a site -- flying between a volcano on one side of the plane and the beach on the other, all bathed in a purple-orange sunset. We weren't in Kansas anymore.
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customs (note to Spaniards: if
you're from Spain, they let you sail right through!
Just ask volunteer Charo Sanchez), Sister Eleanor stood alone to
greet us at the airport. What a smile! After
unloading all 28 tubs of medical supplies, we boarded a chartered bus
for our Guest House. Interesting
sights traveling into the capital city of San Salvador -- some local
highway graffiti spelled out "McDonalds = Corrupcion". Funny, my stomach has said that a time or two as well.
Checking into our Oasis Guest House, we met Simone (a French Canadian delegation coordinator who's accent seemed somehow out of place in El Salvador) and the staff. Many Fanta's and Cervasa's were had! As the evening showers unfolded, the beginning of an unfortunate string began for me -- learning to take a shower by dumping a tub of water over your head (I think Glen is Spanish for "disappearing water").
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We awoke the
next morning to the sound of doves and other birds chirping outside our
open windows. Not unlike a
crisp 30-degree morning in the Oregon desert, although I'd guess our
morning temperatures were closer to 80 degrees.
The day began with a two hour discussion with Manuel Melgar, a
politician roughly equivalent to a U.S. Congressman from the San Pedro
Perulapan district, where we were to do our work.
He highlighted the challenges facing the country, including dense population (El Salvador is roughly 1/3 the size of Washington state, and holds over 6,000,000 people), economic challenges (the country is sustained by Salvadorans working abroad and sending money home to their families), and the continued after effects of the civil war. |
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San Pedro is a municipality consisting of 28,000 people with no hospital, one clinic, and common illnesses, including respiratory problems (the air quality in El Salvador is very poor), gastrointestinal diseases (worms, parasites, poor water quality), back and muscle strain (walking, carrying heavy loads), and stress. |
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The civil war began in 1980 and continued until 1992 when Peace Accords were signed. I cannot attempt to describe this conflict in great detail here, but a general outline highlights that the concentration of wealth among a few limited families--affiliated with the government--generated economic and social injustice. Struggling against this social injustice were the rural poor, who formed the FMLN party. Their quest for social justice was supported by the Church (primarily in the person of Monsignor Romero). |
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When the Peace Accords were signed, a new government structure was created, not too dissimilar from that of the U.S. (three branches of government, supposedly independent of one another). Manuel mentioned that all have agreed to respect the president even if you don't particularly like them, which generated some laughter from the American volunteers (since we're used to this phenomenon in our country). The constitution also called for national healthcare, available to all for free. Unfortunately, however, a 'social quota' (fee) has been created that people must pay to access basic services. Most Salvadorans cannot afford such a fee. |
| Manuel was also joined by Leslie (you may notice during these writings that I use mostly first names -- didn't get all those last names written down), who is the Director of CIS, an organization that fosters solidarity between peoples through grass-roots efforts such as the PazSalud medical brigade. We were also joined by Delmi, a local leader of the Citizens Roundtable in San Pedro Perulapan. She warmly clued us into the fact that we were about to embark on quite a bit of hard work, and that we would be accompanied and assisted by local clinicians, dentists, and other health promoters from the Ministry of Health. |  |
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Finally, we were briefed by Simone on local customs, and we did some on-the-spot clinic design to come up with our staffing model for a Pharmacy, Gynecological room, Pediatrician room, two General Medicine rooms, Optometry room, and a room for urine and blood testing. With our clinic design firmed up, we spent the afternoon on two emotional and memorable tours -- Romero's church and Hospital Rosales. |
| Our first stop was the church where Monsignor Romero lived, preached, and was assassinated. Sister Bernardita, a Carmelite nun, gave a brief presentation in the sanctuary. She explained Romero's transformation from a leader somewhat affiliated with the government to a man of the people who spent the majority of his time with the rural poor and was not afraid to speak out on social injustice and abuse. She also told the story of his assassination, which took place at the very spot we were sitting and that I was taking pictures-- as Romero stood at the altar, a journalist took a flash picture at the very instant the assassin fired a rifle bullet through the open church doors from a parked car just outside. In the confusion, the congregation initially believed the photographer had a trick camera that had fired the fatal shot, but as the car screamed off they realized otherwise (note to self: I wasn't aware of this story as I took flash pictures that probably scared the dickens out of Sr. Bernardita -- might be good to do some pre-reading before traveling abroad next time. What a klutz). |  Sister Bernardita retells the story of Romero's assasination. |
 Street where assassin parked and shot Romero through the open church doors. |
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The bullet pierced Romero's chest, and he was carried out by the Sisters and others at the scene. Sister Bernardita then gave us a tour of Romero's small home on the church grounds, where they have a tiny museum of artifacts from his life, including the shirt and robes he was wearing when he was killed. The stains of war. |
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Next we toured Hospital Rosales, the primary hospital in San Salvador -- this is the place where all those in need of healthcare can theoretically be seen. We met with the Board of Directors of the local employees union, and discussed the challenges the hospital faces, as well as other societal issues such as the pending free trade agreement. This group made a point to express their sorrow to us Americans for the tragedy of September 11th, and to express their solidarity with the people of the U.S. |
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The wards and scenes at Rosales are nearly
indescribable, particularly for those of us accustomed to our
state-of-the-art PeaceHealth hospitals.
There are often two people to a bed, there are no hospital
clothes for patients, no acetaminophen, no water, and patients are asked
to pay their 'social quota' to cover the costs of their surgeries
(supplies, etc). Most
cannot. We saw patients
being treated in hallways, and open wards with no screens between beds that
contained up to 50 men. I
clutched my camera on several occasions wanting to take a picture to try
to capture the bleak scene before us, but was unable to do so.
As we ended our tour and were preparing to leave, we were hoping for one more nurse to walk by to get a picture of their snow white uniforms with matching nursing hats. Just then, a bed was wheeled around a corner with a patient, and we thought this might be our chance.
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But then we noticed the sheets were covering the patient's head. The red stain soaking through the sheets onto the gurney and then the floor confirmed what we instantly knew. Some discussed taking this picture, but my thought was to respect human dignity, and ask myself if it were my body, would I want my picture taken? The body was still sitting there as we walked away. The picture not taken. |
| I glanced up and noticed these two beds sitting in a courtyard, and they seemed to say as much about Rosales as I could muster on this day. Lest you think these are two beds under disrepair and not being used, I would estimate that they were very similar to the beds in use in the wards we saw. |
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Returning to
our Oasis Guest House in San Salvador (that name came to mean everything
you associate with an oasis), we dove into a controlled chaos to
organize and pack our Rubbermaid tubs for the following day -- our first
day treating patients. The
PazSalud mission has received over two tons (yes, over 4,000 pounds) of
medications, vitamins, and other supplies from the Catholic Medical
Mission Board, many of which we were preparing to use.
There were also corrective glasses to organize, surgery
equipment, ear, nose and throat devices, blood pressure cuffs, urine
cups, gynecological equipment, scales, you name it.
I also spent some time figuring out how to ration out the toys I had collected from a toy drive, so that I would have enough for all five days of work in the 'campo'. |
| In the midst of this furious activity, Charo somehow got the
staff to help her run to the store and buy ice cream from
"Pops", one of the Sister's favorite places (judging from all
the plastic containers they have at their home!).
It was on to bed with thoughts of anticipation of what tomorrow would bring. . . . . . .
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