Day 7~June 18
The day started out hot, and the scratching noise the bugs make here is a sure sign of a hot day ahead, our group leader assures us. The bugs were not wrong. We had some free time in the morning, which was a great opportunity for people to take their laundry to the Laundromat just a few doors down the hill from our hotel. Two from our group did so, and found the owner in the shower, but willing to step out to help them. People are so accommodating here--and I’m not just saying that to be funny, they really, really are. I still can’t believe how giving people in the villages were yesterday. They invited us to their homes for coffee, bought bottled water for us, made us handicrafts. To me it is unbelievable how generous they are!
The mosquitoes are nibbling at my feet as I write....those naughty little things I was laughing at a few days ago. Another guest here, who is offering health education to people in the rural areas tells me Dengue Fever is VERY common here, and to watch the mosquitoes. She says it will not show up until days after someone is infected...and you will not die of it, but the fever is quite uncomfortable. I’m thinking the DEET I brought along is less risky and easier to endure, but it’s hard to stay on top of it. I’ve been bitten probably 15 times since my arrival. One interesting note: the woman who told me this is from Valencia, Spain. She said she was talking with girls in a local village, and found 10 young girls, all age 13, pregnant. Worse yet, they are pregnant by their fathers and uncles. In some of these places, the girls are never taught that this is unacceptable. They didn’t believe her at first when she said it is not supposed to happen, that you should say no. They thought it was that way everywhere in the world. She and I had a long discussion that night about how difficult the information we’re getting here can be to absorb.
We headed to the Divinia Providencia Chapel and the bungalow of Archbishop Oscar Romero. There, a Carmelite nun taught us all about Romero´s background...from his life as a little boy, when he was blessed by a priest and told he would become Bishop....to his years as an adult, living in fear for his life. We toured his bungalow, and heard how avocados would fall from the tree in his yard, and he feared it meant people were there to kill him at last. That happened even one night before he was assassinated. We saw the vestments, the fading blood stains, the bullet holes and the photographs. In March of 1980, a journalist had asked Oscar Romero to do the Mass in honor of his mother. As they were supposedly friends, Romero agreed. The journalist didn’t have time to notify friends and family, so instead, put an announcement in the newspaper. At the Mass, Archbishop Romero was preparing the gifts at the altar when a sharpshooter, aiming from a vehicle parked right outside the church doors, shot him in the heart. He fell beside the altar and died. The voice for the poor and marginalized had been silenced.
After learning the history of Archbishop Romero, we had Mass in the chapel where Romero was murdered, with a priest/member of our group presiding. It was a moving tribute to the life of a much-loved man whose vision lives on in the hearts of the people here. How incredible it is to witness, first-hand, the influence of this champion for justice, peace and human rights. You don’t have to be Catholic to appreciate all he’s done and all the work that people continue to do in his name...it transcends religious boundaries. I know. I’m not Catholic, and it touches me!
We returned to the hotel for lunch, (no, we never stop eating here!) then headed to Hospital Rosales in San Salvador, a hospital which serves only the poor, and serves 95% of the population of El Salvador. This is a level 3 hospital, so they handle the most serious of cases, cases where there is a risk a patient might die. A fascinating surgeon led us on our tour and gave us information about the hospital. I found it difficult not to bombard her with questions!
The hospital was built in 1904. It is financed by the Salvadoran government and run by the Ministry of Health, but as you can see by the photos, that doesn’t mean much. In fact, the government gives only 1.8% of the internal product to this health care which serves the poor. The physician we spoke with says it should be more like 8%. The hospital, which is quite large, has separate wings for men and women. They have 525 beds functioning, and more are available but they do not have the money for staffing required to fill those beds. They see more than 800 patients a day and do an estimated 115 emergency consultations per day. They deal with major issues requiring specialty care: trauma, neurology, cardiology, chemotherapy, dialysis, metabolic syndromes. They do this with a staff of 180....many of whom are only hired for two hours per week. While most hospitals try to stay to the 80% occupancy mark, this hospital surpasses the 100% mark.
Besides working in a building assembled (sent on a boat from Belgium and truly assembled) in 1904, the staff faces many challenges in caring for the poor here, most of them related to funding. For example, if a patient has heart problems and requires a pacemaker, the patient himself must cover the cost of the technology. So while the surgery is covered, the patient would have to pay about $1000 for the pacemaker. This hospital draws people from all over the country, and you know how little money they make. No one with money would come to this hospital....they go to the United States for their health care, or to Cuba, believe it or not! Many who need pacemakers and can’t afford them are forced to use a temporary pacemaker, and therefore need to stay in the hospital. So, if anyone out there has access to pacemakers, even used ones, this hospital will put them to good use. I will be glad to make sure they arrive where they are needed. Think what a tremendous gift that would be for someone. From what I understand, the U.S. does not reuse them, but in El Salvador, they’ll take what they can get.
Another tremendous need is medicines. If the budget runs short, which it often does, that means patients who need medications may be forced to go without. Staff will do what they can, but the surgeon told us that they sometimes run out of antibiotics, and that means people who could get well with the help of a relatively simple medication, die. Once they went three months without medicines.
56% of cancer is in developing countries, according to some reports, and El Salvador is no exception--cancer is among their biggest health problems. The surgeon we spoke with said it is believed that several factors could contribute: the inequity of exiting ¨free trade¨agreements allows foreign companies to dump waste, including nuclear waste, without penalty. Environmental pollution is likely also a factor.
Kidney disease is another huge issue. They treat 90 dialysis patients per day, on a rotating basis, and at least 30-40 new patients need treatment every week. Why the high level of need? Possible factors include constant dehydration (and perhaps paired with heavy alcohol consumption), overuse of pain relievers and drinking polluted water.
Violence brings in a lot of patients to this hospital, and gang violence ranks high. We saw one obvious gang member who was bloodied and lying on a gurney in the middle of the trauma area, surrounded by a rush of people. The source of his injuries was unclear.
The good news is, this hospital has two new buildings. The Salvadoran government made a deal with the Japanese government, and gave them an old hospital building in exchange for them building two new ones for this hospital. One building opened June 7, and it is absolutely beautiful. While the rest of the hospital looks like a horror film...chipped walls, walkways with holes in them, shrouded corpses on beds in the outdoor hallways, and only curtains to separate the multitude of patients...these new buildings look as beautiful as parts of Franciscan Skemp Healthcare in La Crosse. The surgeon said they were moved to tears when it opened, ¨Because the patients deserve it.¨ They also just added a CT scanner, the first time they’ve had use of this technology.
This surgeon, after 14 years of training, working full-time with this hospital, earns $1,200 per month. A nurse earns $550 per month. A janitor...$200. Why does she stay? ¨My people need me.¨
She says the most important components of health care are equality, solidarity and justice. That means financial equality, equality in the level of care patients receive, and equality in access to technology.
Before touring the hospital the strangest thing happened. A woman on the street pounded me on the back twice as I walked by. I had smiled at her, and was shocked by this physical encounter. I turned around and I can’t even remember what I said...I thought maybe she was angry with me, or something. The rest of the group was ahead of me. She said, totally straight faced, ¨guapa.¨ I wasn’t sure I heard her, and she repeated it, ¨guapa.¨ Only later did I realize she was telling me I am pretty. Now, how about that? (Can I extend my stay?)
For dinner, we drove up near the first place we had lunch, high above the city, to a place called Paty´s Pupuseria. In back, three women were working to shell and roast cacao beans for the hot chocolate served in the restaurant. Wow! The smell was incredible: rich and dark. They let me taste the beans. Hmmm. Bitter. Not as good as the smell. Well, I had to try them.
The place was packed with locals (I just LOVE that!) and the kitchen staff let me get up close to take photos of the pupusas being filled and patted into shape, then fried. You can almost smell them just by looking at these shots! They brought them out to us, huge steaming piles of pupusas, served with a spicy pickled cabbage salad and tomato sauce. Our van driver and I have an ongoing game...he argues in favor of carne--meat-- and I argue the benefits of vegetables. He doesn’t speak English and I don’t speak much Spanish, so our arguments consist of: ¨Carne!¨ and ¨No carne, verduras!¨ And so forth. Tonight, as we drove away from the pupuseria, and headed for an ice cream place, POPS, we argued over whether helado (ice cream) would be better con carne or con verduras. His laugh is sweet and catchy, and he’s a fun guy to tease. Even more evidence of how great the people are here. I’ve yet to find evidence to the contrary.
You know, a lot of people worry about the theft here, but all I can say is the people of El Salvador have stolen my heart.
If you would like to send a comment, please send email to GATE@fspa.org
"Sheri, I am simply amazed by your experience. Thank you for sharing it."
"Thank you! Thank you! Thank you, Charish, for your daily review of the GATE experiences. I can’t wait to read it each morning. Blessings on your final days there and then safe flights home. Eager to see you and Karen back here."
--Mary Ann Gschwind, FSPA
Day 8~June 19
Thank you to all who have posted messages to the site! I can’t tell you how much they mean to me. I’ve been sharing them with the others involved in this GATE journey. It’s so amazing to have this connection to home while in an experiential whirlwind!
This morning we had breakfast earlier than usual, because we had a long drive ahead of ourselves. For the long drives, we get an enormous, luxurious bus....okay, it’s not a coach or anything, but it has air conditioning and huge windows with which to view the countryside, and I think it’s so grand! Our drive was 1.5 hours long, and took us through the state of La Paz and into San Vicente. Our stopping place: San Carlos Lempa-Lower Lempa for a conversation with Emilio Espin, who is changing El Salvador from the inside-out. One of the main ways he’s changing it: with CHEESE. This is my kind of man!
Twenty-five years ago, Emilio came to El Salvador from Barcelona, Spain, wanting to make a difference. In 1992, when the peace accords were signed, he was just getting started. The land where he currently lives and works was nothing...no schools, no businesses, no drinking water, nothing but excellent soil and the Lempa River. With a background in marketing and business, and a dream, he set out to create what we see today, a cooperative that integrates many angles of life to create what many might consider utopia. Historically, the area grew mainly cotton and grains, and was used for grazing cattle. But the constant use of the land required pesticides, which were spread by airplane to cover a large area. Today, the groundwater in Lower Lempa still shows evidence of DDT. But Emilio and his cooperative are making things right with Mother Earth. So in 1992 he had a vision for the 400 families who returned to the area after the war. (Interestingly, during the war, people left the area, and it was controlled by the FMLN...the guerillas...and served as a channel through which to transport arms and food.) He and others worked together to develop a diagnostic tool for an overview of the area. They asked people, ¨What is your dream for development in this area?¨And, they developed a three phase plan--for immediate, middle range and long range goals.
With the help of students from UCA and the National University, they put together an urban plan for housing, farming, a church, a community center and a soccer field. They started programs for youth, for women, for men. They worked with farmers to create an organic community, to offer a diversity of crops and to differentiate their products in the marketplace. They focused on doing things locally, and boy, have they done well. Today, they sell gourmet cheeses which are in demand even among the rich. After tasting them, I can see why! They’re fantastic. They also have an organic cashew organization, and they create and sell organic dried fruits, candies and other treats. Plus, they bottle and sell a substance no one is selling right now....the juice from the fruit of the cashew tree. See, the fruit of the cashew tree only produces one nut, and it hangs like a hook from the bottom of what’s called the false fruit. In the past, people have just thrown away the rest. But, this organization is taking the juice of that false fruit and making a delicious drink that tastes faintly of cashews and a little bit like caramel corn.
Everything they do focuses on solidarity: preservation of the planet, cooperative harvests, fair living wages for people....it’s absolutely inspiring to see the work they are doing! They call it Cordes Bajo Lempa. Check it out at www.gbajolempa.net .
We had lunch at the restaurant on the property, and it was --of course-- all locally produced foods!
We then toured the cashew cooperative, called SAMO. If you saw how labor intensive cashews are to process, you’d never complain about the cost! Each nut must be boiled in oil for a couple of minutes, then roasted in a 350 degree oven for 1.5 hours. Then, each one is broken open by hand with a rock, then the papery outside is removed by hand.....then sorted by hand. Most of this happens in a room so hot you could cry, except you’ve sweated out any tears you might have had. Amazing!
Members of the group then took us to one member of the cooperative, Hostal Lempa Mar, which focuses on Eco Agro Tourism. The place is stunning, right on the banks of the Lempa River. For just $15 per night, per room, you can stay in a cozy cottage. Beer there is $1 per bottle. It’s relaxing and naturally beautiful. I wanted to stay and never leave. They also have a Web site: www.lempamar.com . We took a boat ride down the river to where it empties into the Pacific, toured an island, and watched the birds and fish (some swim on top of the water and have four eyes, said our guide!) of the area.
You’ve probably noticed by now, particularly if you didn’t know of the GATE program prior to reading this blog, that GATE largely focuses on the poor and marginalized, their struggles, and their victories. That is one purpose, particularly here in El Salvador, where the story of the government is very different than the story the people tell, and the story of the government is well covered by mainstream media. President Tony Saca has been telling the world that El Salvador is no longer a developing country; that it has arrived. He shows the international audience the developed, glossy, rich part of town. This has created problems for charitable causes which depend upon foreign dollars to keep running. Grants are denied these groups based on the good face presented by the Salvadoran government. By now, you know there is another face, one that comprises the experiences of more than 90% of the people here. Lack of financial resources. Lack of clean water. Underemployment and unemployment. Inadequate housing. Inequity in health care. Malnutrition. Mental health issues. Molestation, domestic violence, teen pregnancies.
Tomorrow, we will hear the other side of the story.
We have an appointment at the U.S. Embassy here, and we will have the opportunity to discuss U.S. foreign policy, as well as the work the U.S. Embassy is doing. It should be an interesting morning!
If you would like to send a comment, please send email to GATE@fspa.org
"I cannot believe how beautifully you are describing the days you are experiencing in El Salvador. After reading about the first 2 days, I took out the photo album and my own Journal from the trip made with GATE in 2003. Truly, I am “feeling “ the entire tour again. There are some changes, of course, i.e. the two new buildings at the Hospital.(Hurray!) The co-madres visit made a lasting impression on our group; as did the water “turned on” from a new well the day we visited. What a celebration we had with the village people who no longer had to use only truck water for their water needs. THANK YOU for your wonderful sharing of each day. The March ’08 Guatemala tour is beckoning me now."
"Reading her blog on El Salvador causes me to have a sensory overload, just by reading her experiences!! Excellent writing on the reality of present day El Salvador. Look forward to up coming adventures."
--Love Pops aka bob
"I’ve read everything you have written and it’s a wonderful recall of my time there in 2003. How wonderfully you describe it all! The awful thing is that the situation in El Salvador is getting worse instead of better, lots of it because of the complicity of the U.S. government. It was election time when we were there and our state department had let them know which candidates the U.S. government could work with. It wasn’t the candidates on the side of the poor. Stay well. I miss your “guapa” face in the office here!"
--Sr. Maria Friedman
"Charish—Your GATE blog is compelling. I like your attention to the essence of what you experience. People—their struggles and happy times; history, culture, places, sights, sounds, colors, smells, tastes—leap out through your blog. Splendid photos, too."
--Thanks again and again.
--Charlene Smith, FSPA