Look, Listen and Learn: Unidad de Salud

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 church community.  Four team members worked with the teacher in the school and ran a Vacation Bible School event.  The medical check-ups took place in the tiny, ramshackle church.  The altar was the exam table.  The nurse practitioner examined hundreds of moms and babies and some men.  Her husband managed the few medicines we brought along.  A bilingual nurse from the US translated.  Nurses from a nearby town's Unidad de Salud  weighed and measured people and provided vaccinations.  The mission was grounded in a special worship service and the celebration of baptisms.

The Mission of Healing has grown and changed as the needs of the people have changed.  Fifteen years after its founding, the Holistic Mission of Healing (Misión de Sanación Integral) currently provides a healing experience for people in more than 30 Lutheran Church communities.  The people are bused to two different sites during two weeks of work. Spiritual healing through prayer and massage and educational charlas (chats or discussions) are a main focus.  Salvadoran doctors volunteer alongside US doctors.  Most medications are available and purchased in El Salvador.  The eclectic, healing team consists of about 60 healers (each week) from the US and from El Salvador, always with the accompaniment of the Unidad de Salud.  

What is the Unidad de Salud?  Healthcare in El Salvador is delivered via a tiered system.  Private hospitals and clinics are available for those who have plenty of financial resources.  Workers in the formal economy and their families have seguro or insurance which gives them access to a system of clinics and hospitals.  Medications (if available) are provided without additional cost.  The Unidad de Salud or Health Ministry provides free healthcare for everyone else - about 50% of the population. Anyone can go to the local Unidad clinic for care, and if the patient is insured, the Unidad is compensated.

Beginning in 2008, the national government in El Salvador began to implement a series of healthcare reforms to improve the accessibility and quality of healthcare for the uninsured population.  During recent Missions of Healing, caregivers have noticed the positive effects of the reforms.  As coordinators of the missions, the nurse practitioner and the church worker wanted to learn more.  The two of us received an invitation from the Unidad de Salud in Nejapa to come for an extended time to observe and participate in the daily work of the doctors, nurses and health promoters.  In October 2014, the two of us spent three weeks in the northern zone of El Salvador, with the amazing and caring staff of several Unidades de Salud.  In each location, we introduced ourselves and explained that we were there to look, to listen and to learn.  We were warmly welcomed by each Unidad director and given complete access to observe all aspects of care...and we have some amazing stories to share.

This is the introduction to a series of posts about our three weeks with the Unidad de Salud in the northern micro-region.  My friend and I want to express our deepest gratitude to SIBASI Norte and all of the staff members who shared their time and insights with us.  We believe that the strong connections between the church and the health ministry will be mutually beneficial to the patients and those who care for them.


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