Setting up the Clinic

The church on the grounds where we worked in San Jose Villanueva

Thoughts of a Family Doctor

Paz Salud, El Salvador

February 2012

I’m on the plane now, coming home from the Paz Salud medical mission in El Salvador. We worked out of an elementary school/church in the city of San Jose Villanueva. This is a city with about 15,000 people.

                We arrived in San Salvador on 2/4/12, Saturday night.  It was a typical night in El Salvador…hot and muggy. Quite the shock compared to the climate in the Pacific Northwest. We made it through the airport without difficulty.

Sunday, our first full day

On Sunday, after waking at the beautiful  retreat house. Fidel, my translator, and I went on a walk out of the compound. Fidel is a receiving clerk at Riverbend Hospital, from Mexico, and is a great guy. I came to appreciate his insights into people more and more as the week went on. He and I went outside of the retreat where we stayed, and crossed the main road and wandered into the countryside, or “campo.” There were dogs, and chickens roaming around and the road was alternately paved and rutted gravel. After passing  a home with 2 parrots in a cage, we looked back into the lush hills, and there was a middle aged man RUNNING on a trail, coming down onto the road we were on. When he reached us, Fidel struck up a conversation with him and he walked with us quite a ways. He was a security guard at a funeral home, only working when there was business. He told us there was a river at the end of the hill we were on, and he wanted to show it to us. When we got to the bottom of the hill, there WAS a river that ran over the road. Now it was only a few inches deep on the road, but I imagine it being impassible in the rainy season. He also told us that he was a farmer most of the time, and the land he farms on is leased to him for $8 per year. He produces enough to feed his family, and in good years, he can sell some of the produce for a few extra dollars.

The river at the end of the road.

After Breakfast, we boarded our “Tourist” bus, which was air conditioned and very comfy. 20 minutes later, we arrived at the school/church. 

A view of the very top of the church from outside the walls

Mass started at 10 and those who wanted to go, stayed while the rest of us went on a little self guided walking tour of the city. We found a cemetery that was jam-packed with graves just outside of town that was extraordinary by US standards. There were many tombs on top of the dirt, and even small mausoleums. Most of the graves were decorated with plastic colorful flowers. 

Photo by Barb Bigelow 

There were a couple of young men who were quietly hanging out, sitting on one of the tombs, facing the grave of his brother and grandmother. His brother was only 21 when he was shot in the back of his head  a year and a half years ago. He and his friend were just spending time with him. Very touching.

After services, it was time to change the school into a clinic. To set up the general medicine room, all we needed to do was move the chairs and tables to one side, set up 5 consultation stations, each made of 2 student desks and 4 chairs. We had a nurse’s area, the teacher’s desk, with all the ear irrigation equipment, urine dip bags, and AccuCheck machine and BP cuffs. We also had to enclose a corner of the room with tarps hanging from the ceiling with ropes to make a private consultation room. Charlotte, one of the ER docs from Riverbend, had an ultrasound machine donated (loaned actually) which was used in this room, which also had the exam table used by all of us. Miraculously, a local radiologist was with us the entire week and did all the exams we needed. He did vaginal ultrasounds, found several gall stones, looked at kidneys, even did vascular studies. This was incredibly useful, especially since there were several who had these studies ordered by their doctor, but couldn’t afford the $30 for the study. We were able to do it for free. 

View of the outside of the "clinic" from across the courtyard

Setting up the pharmacy was quite the chore. We had to set up several shelves, label them and then take the medications from the bins and stock the shelves. There were some new shelves that had to be put together, so of course, it was a moment for competition. Britt, the 4^th year medical student and some other women versus me and a few local men. We started out fast, but soon realized that we had the legs in backwards and had to dismantle it. By the time it was taken apart, the ladies were nearly done with theirs. Score one for the ladies.

Unloading the truck, showing off my physique.
Photo by Barb Bigelow 

The Pharmacy, with Moises

The pharmacy staff: Melissa, Moises and Sylvia
Picture by Mary Frazer

Meanwhile, the “eye people” were sorting through all the sun glasses, readers and glasses, putting them in neat rows in boxes. Others were pre-bagging 30 day supplies of vitamins in the break room.

Bob doing an eye exam on Andrea
Photo by Mary Frazer

                By 6, we were ready to return to the retreat for dinner. Meal times were, in general, awesome. Breakfast always had bananas or papaya, granola and bread, plus some other main dish, like beans, pancakes or local dishes whose name I couldn’t ever remember, but were generally tasty and filling. I had to bring my own tea (Tazo Awake) from home. Lunch was served on the long patio of Padre Mario’s house. We had long tables that sat at least 30. We ate in shifts. Always rice and some fruit, along with soup, chicken or beef. There was always plenty for seconds and the 4 women who cooked and served us were so sweet.

Yum

Finally, dinner was some typical local food. Pupuses, tamales and even some little crunchy anchovies…eyes and all. I didn’t eat those.