Walking With El Salvador

There are many times when we look back at moments shared or things accomplished with our sister church in El Salvador that we just shake our heads and marvel.  The connections made and friendships built during our very first little Mission of Healing in our sister church community is one of those moments.  We had never been to our sister church community before, we knew nothing about the neighboring community, Distrito,  nor the little clinic there, but the wisdom of the locals to cultivate relationships between their neighbor nurses and their new US friends has born a lot of fruit over the past 15 years. On Friday, after a couple of days out in the countryside dodging cows and learning about rural, door-to-door medicine, we traveled back to where it all began:  the little clinic in Distrito Italia.   We were pretty excited to go there - to see if maybe some of the original staff was still there, to see how the clinic has changed since our last visit there several years ago, and to c

A calm bit of road which allowed for a photo Another early morning and another long ride out to San Pedro Puxtla.  Upon our arrival we were excited to learn that this day was a truck day!  On truck day, the team has access to the government pick-up truck in order to deliver heavy boxes of medications and supplies to remote sites where once per month the team runs a medical clinic.  The ride to this month's remote site was "in the opposite direction of the ECO base, in an area that scares us because the gangs have come there and sometimes threaten the health workers."  It was sad for us to hear that gang activity had come to this remote location and hard to understand what possible economic value gang members could find in terrorizing these incredibly poor farmers.  We bumped along the road without incident, bracing ourselves so that our heads would not hit the ceiling of the cab.  We could not stop laughing because the bumps were incredible!  We asked if the truck had

We couldn't possibly turn down an invitation to learn about the work of our young doctor friend.  After all, we have known her since she was in the university, and she has been helping us with the Missions of Healing for 6 or 7 years.  So, on Day #2 we loaded up our backpacks with water and set off bright and early for San Pedro Puxtla.  We had directions.  We had a map.  We still got lost.  We stopped many  times for directions, and thanks to a really kind guy in the street who, in the rain, sketched out a map for us in his own notebook, we eventually found our destination. Our friend (la Doctora) is the coordinator for an ECOS ( Equipo Comunitario de Salud) Familiar:   a community-based family health team.  (Usually the Salvadorans just call it an ECO.)  The creation of ECOS throughout the rural areas of El Salvador has been a key strategy within the healthcare reforms that began in 2009.  Each ECO consists of a physician coordinator and support staff such as licensed n

Exterior of the Unidad de Salud One full day.  What would we learn by spending just one full day at the Unidad de Salud  in Guazapa?  It was our first observation day, so we did not know what to expect and we had no reference frame from which to make comparisons.  We were a little nervous - we did not want to be intrusive! In the morning, these chairs are filled with waiting patients The local Lutheran pastors had made the appropriate arrangements for our visit and the director of the Unidad  greeted us warmly.  He is new in his position, but already seemed to be a little familiar with the work of the Lutheran Church pastors and health promoters within the church.  Deb, the nurse practitioner, and I introduced ourselves as representatives of the Salvadoran Lutheran Church and its accompanying sister churches from our synod of the ELCA. (Evangelical Lutheran Church in America).  We explained our purpose:  to look, listen and learn, with the hope that we can more fully align t

We came to look, to listen and to learn.  The two of us, a nurse practitioner and a church worker, did not come to see patients, did not come to bring medications, did not come to fix anything.  We came to look, to listen and to learn. For nearly fifteen years our synod of the ELCA (Evangelical Lutheran Church in America) has accompanied the Salvadoran Lutheran Church in a ministry we call "Missions of Healing."  The Mission of Healing was born at a time in which the people in our sister church community and throughout poor communities in El Salvador did not have access to attentive check-ups or basic medications.  Public clinics hosted long lines of patients who would wait as long as 8 hours for a 1-minute consultation with a doctor and a visit to an empty pharmacy.  Education, especially about sexually transmitted diseases, was sorely needed. The first mission of healing team had seven US members. We broke off from a synod delegation to spend four days in our sister chu

Sometimes it happens.  Plans fall through, transportation becomes a challenge, walking is not an option, so even if it is not your plan A for the day, you end up hanging out at Metrocentro. If you live in San Salvador or visit San Salvador, you know about Metrocentro.  It's a mall.  It's gi-normous.  It's a bus-hub. You go there to window shop.  You go there to meet up with people.  If you are part of a delegation, you go there to run errands at the Dollar Store or Super, or you walk in circles trying to find the food court. One day, recently, a friend and I found ourselves with plans that just could not get organized and there we were, with several hours to spend at Metrocentro.  We decided to embrace the experience, walking and walking, eating and eating, shopping and shopping.  This was hard-core, delegation-leader research:  figuring out which food courts have the best seating, which fru-fru coffee drinks are the tastiest, which places have fee wifi, and where to bu

Photo taken in the Cultural House in Dulce Nombre de Maria, Chalatenango If you search the internet for Caballero de la Noche  (literally "Cowboy of the Night"), you will find an endless list of references to Batman.  However, throughout the countryside and small hamlets of El Salvador, a question asked about the Caballero de la Noche  brings forth tales of fear and the devil... The Horse-Rider of the Night is a being which causes panic and fear.  Of course, if the Devil appeared to us as himself, we would die of fright because of his monstrous image.  But as you know, the Devil is a clever devil, and to appear as an ugly animal would be absurd.  So he appears in the most attractive way possible. It is said that a long time ago, some land-owners suddenly disappeared, and then some reappeared as dead horsemen with insides made of nothing but straw.  How did this happen?  It is said that whenever bad luck surrounded men or for reasons of life they despaired, they wou

In honor of Halloween...here is the story of La Carreta Chillona This photo was taken in the Cultural House in Dulce de Nombre de Maria, Chalatenango Throughout El Salvador, the midnight sound of squeaky wheels rolling down pavement, cobbles or pathways of a town brings fear to those who hear it.  The cart passes by at the time when everyone should be asleep, so that no person of the town would be exposed to the company of cadavers traveling by cart on their funeral route.  Some believe the cart is filled with the bodies of those who have dared to look upon the squeaky cart as it passed by. Many people claim to have heard the squeaky cart, and many people will describe its distinctive adornment with skulls, but I have not yet met a person who has taken a peek as it passes by in the night. Historians believe that versions of this tale were spread throughout the Americas by Spanish rulers, who wanted to discourage the local people from venturing out after dark to conspire against

"See you at the fair!"  As we made our way to church early in the morning on Sunday, women from the community made their excuses and made their way to the bus stop.  Church is important, but the opportunity to market themselves and their products took priority. After worship, we made our way to Tonacatepeque, to the sidewalk in front of the mayor's office.  The fair was small, but the mood was hopeful.  There were not too many people buying things.  We wondered how well the event was promoted to customers. We wandered from table to table, and we did do a little Christmas shopping - which means our purchases are still top-secret!  I asked if I could take a photo of the woman who sold me a beautifully crocheted item...as a memory for the person who will receive the gift.  This creative business woman also sells natural medicine made from herbs in her garden. The hand-made items ranged from embroidered cloths and blouses, to knit and crocheted items, to hand-sewn s

Every now and then, I take a ride through San Salvador with my camera at the ready.  I stick it out the window and click...never knowing what images I might capture.  Despite the rainy weather, I managed to collect a few images from October 2014: Arbol del Fuego - Tree of Fire -- blooming in full force all across the city and countryside It's hard to appreciate just how closely we drive next to the buses when in the center of the city This photo is not auto-corrected - this is the real color of the sky on this day...the blue and white of the sky reminded me of the Salvadoran flag...which, appropriately, is flying next to the monument to the constitution The mayor's office in this municipality adjacent to San Salvador has a huge problem organizing trash pick-up Along the round-abouts on the north side of the city, people sell a variety of things, from coconuts to furniture.  During October, kites are for sale because the winds usually come and it

Chikungunya.  Most Salvadorans just call it "Chik." Chik scares people.  "Our bodies have no memory of this disease, so we cannot fight it."  It runs through family members in rapid succession.  Data indicates that the majority of victims are teens and young adults.  Parents are frightened to see their energetic youth suddenly stricken by fever, severe headache, joint pain and a red, itchy rash.  For some, the joint pain is so severe that victims cannot walk or stand, and pain seems to linger in the wrists after the other symptoms have passed.  For some, rehydration with IV fluids is needed. Clinics are inundated with cases of Chik.  Doctors are seeing four times the number of patients usually seen in a day.  Pregnant women, people with chronic illnesses and high-risk patients are hospitalized.  Treatment consists of taking acetaminophen for the pain and drinking lots and lots of fluids, especially Suero .  For some, complications occur when patients take ibupro

The town is small.  The municipality is large.  The small government clinic attends to the needs of people who do not have healthcare.  These are people who work in the informal economy and much of the care is centered around pregnancy, birth, the care of young children and of old women.  A few men come in for check-ups and vaccines.  This community north of San Salvador includes a broad range of living conditions, and the care area is huge. Today we accompanied the chief doctor, the head nurse and a health promoter as they did a home visit to investigate the death of a 2 year old boy who reportedly died of malnutrition.  We were told to prepare to walk a long distance.  We were told to carry water.  We were told that the child died because the family did not care for him properly.  There were many things which were not told.  The reality of this dead child's short life and the lives of others in the home leaked out secret by secret, breaking our hearts bit by bit. A little boy

We drove down the second most bumpy road of the day.  It was a long distance from the clinic, too far to walk for a child or for a mom who is weak from illness.  It's no wonder the mom missed her appointment.  The doctor or the health promoters sometimes walk to visit the patient, but with today's access to the health ministry's pickup truck, the team was able to drive.  As we bumped along, my friend and I almost wondered if it would be easier on our bodies to walk than to be jolted side to side, despite the hot sun. The two of us are shadowing a community-based family health team (called an "ECO").  Healthcare reform was implemented during the Funes administration, and the Salvadoran government continues to work to increase the number of ECO's in rural communities.  This ECO is based in a converted community center and depends on the cooperation and fund-raising capacity of the local mayor's office, community leaders and the medical team in order to be

After marching with flags, balloons and a few thousand other Lutherans through the hot, sunny streets of San Salvador; after listening to speeches, admiring community banners, honoring the king and queen of the national youth group, singing a couple of songs and clapping wildly for the youth dancers; after listening to the story of the Subversive Cross; after meandering over to Pizza Hut for a quick lunch and a bit of luscious air conditioning ... we were ready to celebrate corn. Every year, the Corn Fiesta is celebrated on the afternoon of the Anniversary Celebration for the Salvadoran Lutheran Church.  A few years ago, the planning for the Corn Fiesta was turned over to the youth.  Maybe this is a way in which to make an old tradition seem fun for the younger crowd.  As the afternoon sun baked the pavement, gringos piled out of their little buses and Salvadorans emerged from their community trucks and cars, and headed toward the covered area near the big portrait of Jesus.  People