El Salvador--Day 5

Dr Steve, Lydia, Me, and Monica

 This morning, we had eggs with vegetables, refried black beans, tamales, cafe and fresh fruit. We left for our next clinic at Oasis (Oh-ah-sees). They recently had a few young ladies paint new murals on the walls. The mural where we are standing says JESUS HEALS. It's next to the clinic exam room that they have there.

They had supplies for me to do some well woman exams. Several of the women hadn’t had one for many years. The table was a narrow gurney which had no brakes and no stirrups. They used a step stool to get on it, and there really wasn't access to good sanitation barriers-adequate to get the job done, but it wouldn't have passed the regulations in the US. The tools were archaic and took me a minute to figure out. I had a head lamp on to see (usually the lights are right in the tools we use to see). It was an experience to say the least, but the women were so grateful. One thanked me and gave me a big hug for taking care of her. I just hope that the pap slides that I  made were useable later!

Sylvita was the interpreter that helped me the most. She's a petite little thing!! She is in her late 20's or early 30's and super sweet. She works full time for Christ For the City International. She teaches English to the kids as well as some other things. 

We walked to the clinic today. It was only a few blocks. This lady lives next door to sister Magdalena. I happened to notice that she was drawing her water from a well. I didn't have the chance to ask anyone how routine that is, but I am going to guess pretty common!

Here is the set up at Sister Magdalena's. The shallow rectangular sink is also the "washing machine." We used it for hand washing. The procedure was to fill up one of those small blue pans with water from the circular vessel. Use the soap in the right hand corner of the rectangle sink, and then use the fresh water in the pan to rinse off. To the left of the rectangle was the eating area, and about 30 steps to the right of the circle was the kitchen. 

Here is a picture of the kitchen. There is a deep freezer in the back right hand side of the room, and a refrigerator to the left that isn't visible in the picture. She also has a large flat cook top (think Blackstone without the brand name) next to the red chair on the left. The dishwashing sink is in the back left hand corner. The picture looks bright, but that one light bulb up there doesn't light up much. It seemed really dark in there all the time. 

Here is a picture at the shower room. You can see that the tin roof fits only "loosely" onto the building. The shower is on the left and the toilet is behind the green curtain at the right. The girls bedroom was connected to the bathroom-to the left of the shower. 

There was also a cement sink in the bathroom area. 

This is the "lock" from inside the bathroom. The door was a wood framed piece of tin.

Now, back to the clinic. Again, people were already waiting on us when we arrived. This was a beautiful little place with a new, improved kitchen that they use to serve the community. They actually use it to supply meals to some of the most food-insecure people in this little community.

In the clinic room is a small air conditioner. It felt good for the half of the day that I got to do well woman exams. The rest of the time, Dr Miller and Dr Steve did lesion removals and benign tumor removals, and Lydia stitched them up. 

Dr Morataya and I saw clinic patients upstairs in the open air patio. There was another big tin roof over the top of it to keep the sun from us. It was BEAUTIFUL!! There was a slight breeze that felt SO good in the hot, humid climate.

In the extra suitcase I brought, between the plastic shoeboxes filled with eye glasses, I had stuffed snap bracelets, punch balloons, sunglasses, story books, and as many stuffed animals as I could shove in the crevices and dead space. The kids LOVED the snap bracelets. They had actually never seen anything like them. I could tell by the way their eyes lit up when I demonstrated it on my arm first. They were always willing to put their arms out to receive one for themselves. 

At the end of the day, Sylvita was looking through the suitcase of toys. She remarked at how cute the stuffed strawberry was. I told her she could have it if she wanted...She jumped at that right away. Edwin asked if he could also have a stuffed animal. He picked through them all and chose the little dog. He snuggled it up to his face in the sweetest way. When I asked if he had ever had a stuffed animal before he replied that he had never. My heart tugged at the thought of that. Most American kids have so many stuffed animals that they don't know what to do with them. And these young adults had never had the opportunity to love one! The little one on the right is Sister Magdalena's granddaughter. She also chose a little bear...and she carried it around for the next two days! If I ever go again, stuffed animals will for sure make the final cut for placement in the suitcases!

From the balcony clinic area, I caught a glance of a couple young boys. I had seen them the day before riding bicycles with these really long sticks. The sticks had a little enclosure on one end, we thought maybe to catch something out of the water. 

It turns out, they gather mangos with them. They were grabbing mangos down out of the trees with ease and piling them in a bowl. 

Here is our medical team--left to right

Edwin (translator), Francisco (dental assistant), Dr Morataya (medical director and doctor at the mission house) Raquel (pharmacist), Dr Steve from New York, Lydia, nurse practitioner from San Antonio, Sylvita (translator), Vanessa (dentist), Me, Monica (dental assistant, leader, Dr Miller's wife), Dr Miller (leader)

We walked back down the dirty roads to Sister Magdalena's. People were going by most of the day on bicycles or motorcycles. Sometimes there would be an old truck. Chickens were everywhere, being followed by millions of chicks. Someone counted, and a chicken we saw at the clinic that day had 28 baby chicks following her everywhere she went!!

We met this beautiful woman on our way home. She was happy to meet us. Teresa was her name. She was 78. 

A cashew tree!! It was the darndest thing I have ever seen!! The fruit (above the cashew shaped nut) turns a bright red.  Apparently they don't taste that good though. 

Here is a cluster of cashews!!

A picture of Edwin and I. He and I had a fun, teasing relationship. He was also good to translate things for all of us throughout the day--to patients or to one another on our team. 

Spanish was harder today. I can speak some basic things, but advancing it from there has been frustrating. Using the right word in the right sentence seems more difficult, and by the end of the day, I couldn’t even speak the things I know how to say. I was hoping that this experience would help my Spanish to improve, but I think it really only made me more confused. I am finding myself more motivated to get my Rosetta Stone system out when I get home and begin practicing. I hope tomorrow will be better as far as the language goes.

The people are grateful for the care. Several of them are taking medications. This is evidence that the sponsored doctors coming weekly is helping people to take better care of themselves. That is encouraging! I have had several kids over the last few days that are having pain in their feet, ankles, and knees that I am certain is related to the bad shoes that they wear. Another point of frustration for me. It doesn't matter how much medicine we have or don't have. If we can't fix the root of the problem (like decent shoes to wear), how can we effectively treat their problems for the long term. A lot of teaching went on about body mechanics and ways to stretch out their bodies to minimize the chronic pain that many of them experience. This will be something that I will have to sort through over the weeks to come...and a reminder to me, that, while I came to serve these people, the tension over helping in a few ways and not having the means to help in other ways is a real, real problem!

Francisco and I took a better picture earlier in the day with our medical garb on...but I was afraid I might never get it from his phone (mine was downstairs)..so we took another one before we left for the day

Dinner tonight was a hard-boiled egg salad with chunks of avocado, onion and radish slices. I hate radishes. But, not willing to pick things out, I ate them. They were pretty darn tasty. We also had fresh fruit, refried beans, and thick tortillas.

We have one more clinic tomorrow morning. Tonight was spent trying to rearrange my suitcase to get packed back up. After lunch, we will be heading back to the mainland to get COVID tests done to get back into the US..and to head for the Air BNB that we will spend the night in on the beach. It's hard to believe that our week is nearly finished!

                                                        All the Poor and Powerless

El Salvador-Day 4

 This morning we bid farewell to San Salvador as we climbed aboard these little motor boats headed for the port of Ranchon on Island La Calzada--a little "forgotten" island. We drove approximately an hour or a little longer to get to the boat launch from the Mission House.

Once we climbed onto the boat, it was about a 30 minute ride through the mangrove forest. The waterways started large, and then as we twisted and turned though the forest, the ways got more narrow. There were lots of water birds to see. 

There were also other boats-mainly with fishermen in them. Most of them were hand carved wooden boats like the two in the picture below!

 

 

They were loading boats when we got to the dock. Lots of fresh goodies!

 When we got off the boat, Dr. Larry and Monica had a meeting to go to. They have been coming to these areas for 6 years now and they have made the decision to invest in this community as much as they can! They are currently trying to accrue a piece of land to build a permanent clinic on the island. They also have a donor willing to finance a water system on the Island. Right now, there is a sketchy 4 inch plastic pipe that transports water from the mainland to this little island!! We drove underneath it on our boat ride into the island.

Dr Steven and I were given permission to walk around a bit to check things out as we waited on the rest of our crew and our supplies and baggage. With my camera in tow and an eager spirit, we took off!

Houses were stick and mud; brick and mud; stick only; and some had adobe covering

We turned onto a different street and I said “I’m pretty geographically challenged, so I won’t be any help finding our way home,” to which Steve replied, “Oh, I think we will be OK.” So we continued to walk and chat and my eye was to the sky looking at the flowers and produce on the trees…as well as from side to side looking at all of the little properties in the neighborhood and the primitive simplicity of it all.

We decided to finish walking the last little stent so we could get a picture of their really skinny cows. So we did. Turned right around, and walked right back where we came from….except, that the turn that we made, was onto the wrong “street!”

sugar cane crop

We walked and walked and in a bit became worried that we weren’t where we thought we were…SOOO… at this point. We have one phone with no service. Neither of us speak any relevant Spanish. It’s hot and we didn’t bring any water. We began to walk faster because we knew our team was going to need our help to unload…and I am becoming totally freaked out, because there are little roads going absolutely EVERYWHERE through this village. How in the WORLD are they EVER going to find us here.

The island has around 1500 people on it, and 4 small communities. We began asking everyone we saw to help us get to the school…or to the boat dock. They would ask questions that we couldn’t understand or answer. They would give us some hand motion directions accompanied by a lot of words…and we would say Muchas Gracias…and keep going.

We finally made it to A boat dock…and a woman that had a little more compassion. I begged her to go with us to show us where to turn...she had sleeping babies, that much we understood! So we took her directions the best we could understand them and kept going! Within about 10 more minutes, we had made it back to the clinic site… BEET red and so thirsty. JUST in time to fall into line to walk into the clinic that was ready to start.

I thought I recognized this woman later in the afternoon. She confided in Monica that she had seen us when we were lost. SHE was the woman that I was begging to take us back to the school!

The funniest thing was, that several of the people that we had talked to that morning, we saw later in the clinics…and either they recognized us, or we recognized them. Because Monica knew where most of them lived, she would say, “oh, you were way over there?? And then for the next person we recognized that we had seen, she would say, OH, you were all the way over THERE? She confirmed that we indeed, had walked a LONG way. It was a scary experience for sure, but one that I can heartily laugh at now!

Just another little homestead

I enjoyed this clinic so much. We saw many people. We took our own blood pressures and did our own finger stick blood sugars and a LOT of teaching. It was medicine at its most primitive and the most beautiful. The only thing that would have made it better, was being able to speak and understand more of the language!! It was also a very good reminder as to how fortunate we are in the US in the medical field with so many resources available to us!

 

 

If you read yesterday's post, you will recognize this story again. But it was SOOO important as a sign of God's faithfulness that I want to recap it again!  

One of the cool stories I have about God preparing me for this trip, was that my 8 year old stethoscope was wearing out and I was going to need to get a new one. I had heard from a peer about a new one that has noise cancellation and sound amplification. I looked at it literally for SIX weeks, unable to decide if I wanted to spend the money--it was double what a normal steth costs. I argued all the points, I rarely EVER work in the ER anymore or other noisy places where it would come in most handy. I could consider getting one in another 8 years when the  next one wears out…It seemed extravagant and unnecessary. BUT…after 6 weeks of putting it off and putting it off, one day I just decided to get the amplification steth. I practiced with it for a few weeks and loved it…But on these clinic days where 5 providers and translators and dentists were all crowded into cinderblock rooms to see patients, I knew that the Lord had prompted me to get the stethoscope ahead of time so I had it for the trip. It made all the difference in the world as I examined these people!!

This little tiny thing was our pharmacist!!

We loaded all the equipment back onto the boats, and they took us further up the Isla to Sister Magdalena’s house. She and her husband pastor a local church. She has a humble little cinderblock house with a tin roof, and another little building that has one dorm room with 6 beds and the bathroom that E.V.E.R.Y.O.N.E uses. So trying to get all 18 or so of us through the shower and toilet was insane!! The shower was cold. No hot water here. I do have pictures to show of their home in the next post! 

There was electricity but only 2 outlets in our room and lights in the house. I know that I didn’t mention it earlier, but they are unable to deal with toilet paper in their septic systems, so every place has a little trash can next to the toilet. You wipe and throw it into the can. I only forgot once!! They also don't have any type of trash service. There is no place to deal with trash. Most people have a little place that they burn their trash regularly. Around San Salvador, it wasn't uncommon to see little lots turned into trash dumps, and there was a lot of trash in the ditches! I've never really considered what a problem it would be NOT to have something to do with your trash!!

Dr Steve and Sylvita setting up for the clinic

It is mango season here. I didn’t like mangos until today. They picked them right off the tree, washed them and we peeled them with our teeth and ate them like heathens-with mango fibers hanging out of every tooth we have and juice dripping off of our chins and down our elbows. Some mangos we ate with chili lime salt, and some just plain!! They were SO delicious!! BUT, those suckers fall off the tree at their own will, and land on anything underneath them without discretion. And when you are sitting in the dark, and one falls off from 30 feet onto the tin roof, it sounds like someone just got murdered outside your room. It took me several times of this before I stopped jumping! 

Vanessa and her brother Francisco. These two are HILARIOUS! You can tell, even without speaking much Spanish, that they have a love for life and fun. They worked tirelessly on all the patients with dental needs!

All the meals were outdoors under a tin roof. We enjoyed our first pupusas, the best food, allegedly in El Salvador. They are little tortillas, made like bierocks, stuffed with anything they want and then flattened around the filling and cooked on a hot surface. They were delicious. We enjoyed more fresh fruit, delicious avocados, the best refried beans, and fresh queso fresca cheese. We also had fried tamales, but unlike Mexico and US, these didn’t have meat in them, and they were more like a fried sweet corn bread. Very good!!

Most things that get said, including prayers, are translated either from Spanish to English or vice versa, depending on who was talking. As we began to learn one another’s personalities, I could tell so much about what they were saying by how they said it. The dentist, Vanessa, and her brother Francisco and I, would make a joke in our own language, and then the other one would follow it up with a joke in their own language…and then we would laugh and laugh. I have no idea if our jokes or comments even related to what the other had said, but we didn’t care. It was just fun to laugh together!!  You don’t have to speak the same language to connect to people!!

Health clinic held in the school

Before we dispersed to get in line tonight for the showers, we had a great lesson on the Good Samaritan and Romans 12. It was a beautiful reminder that our neighbors aren’t always neighbors logistically, but that anyone that we meet who needs help, is our neighbor. It’s been really rewarding to use my skills both to care for these people that have so little, and to support the medical staff and missionaries in this location-to help encourage them to continue serving and loving these people. Being Christian friends to those who won’t be going home on Saturday…but that will continue to pour out their hearts for the needy right here!!

 Two more days to go!! 

I love the song below. I heard it for the first time the week before I left! It was on a playlist on my treadmill, and I scribbled down some of the lyrics on a pad so I could find the song when I finished my workout...I knew it was another sign from the Lord that I was doing His will!!

keep changing the world

El Salvador--Day 3

 Buenas Dias!

Today, we got up and headed out to a remote village, Ichanquezo, about an hour drive from the mission house. The traffic remains ridiculously busy. I am amazed at how early the traffic starts…around 5:00 or earlier. I've also been surprised at how early we get started. We have been heading out by 7:30 each day, and tomorrow will be 6:30!! The clinic today was held in a church, Tabernaculo de Santidad. We saw patients inside the church walls and it was SO loud!! We had five providers doing patient visits for reasons such as upper respiratory infections, scabies, parasites, and headaches. We also had a dentist and two dental assistants working in that same space!! The walls are like stucco on 3 sides, and then the 4th side is all open!

In December, I started shopping for a new stethoscope. The tubing wears out after a number of years and you don't hear as well. I had heard about a newer type of steth that has amplification and noise cancelling features. It was MUCH more expensive than a regular one, and since I don't work ER anymore, I rarely have a need for the noise canceling. I looked at them for literally 6 weeks before one day in February I decided to pull the trigger and order one. I KNOW without a doubt that God put that desire in my heart, as well as the peace to spend the extra money to buy the upgraded one. It was the best investment ever for this trip!! I had no trouble hearing heart and lung sounds in these small, loud areas that we worked in! That is one of the cool stories of how God provided for me in preparation of this trip!

It seems depression and anxiety also lives in 3rd world countries. I saw 2 teenagers that wanted something for anxiety. Unfortunately, we have a one page paper formulary that includes about 15-20 meds total---for colds to worms to diabetes to high blood pressure. I was able to counsel a little bit about using the bible as a resource to help deal with the emotions...but in depression and anxiety, my experience has been, that people still want other things to help them combat their feelings!

the people were already waiting for us under the makeshift tents when we arrived!

This young lady got a medical exam, a new pair of glasses, and a sweet little bear that was made by the granddaughters of a friend of mine from church!!

she was SO excited by these new prescription sunglasses.....her smile says it all!

The people were absolutely THRILLED with the glasses!! I might have mentioned in a previous post that I had accumulated nearly 200 pair of glasses--from mens/womens/childrens to prescription sunglasses, bifocals, and even reading glasses! A lot of the people were looking through the boxes and trying them out! Quite a few of them found glasses that worked for them! The prescription sunglasses and the reader glasses were the biggest hit!! 

There is also a dentist and her brother, whom she has trained to help. They do deep cleanings, fillings, and teeth pulling.  

In the church, we were unable to bring the dental chairs…so they sat in $5 plastic patio chairs and tipped their heads back over the back rest while they had their work done. It looked SO uncomfortable. But the people wait in line for hours, and they are so grateful for the painful dental problems to be fixed.

I literally watched a 10 year old girl have the biggest baby tooth pulled out that I have ever seen!! She took it like a champ.

My Spanish is definitely worse than I thought, and sometimes it is hard to converse even with our 2 translators. Edwin, is a young man who desires to work in the mission full time. He is working very hard and doing a great job, but there are just some English words…especially medical terms…that neither he nor Sylvita, our other translator, can translate. I have always been one to talk with my hands before…but I am getting really good with charades…even with our Spanish teammates who work in the dentistry and pharmacy. A good facial expression and tone of voice and translate a lot of things!! We laugh a lot. 

an outdoor kitchen where the church ladies cooked all day to feed our team, including snacks at the end!

By the time we left the clinic and headed back for the hour drive, we got there and literally had 15 minutes to “freshen up,” whatever that looked like. We got BACK in the van and drove ANOTHER hour to get to a very beautiful restaurant on the side of a volcano.

The dusk and sunset views were like none-other. It was really ethereal because we were higher than the clouds, and the way the sunset reflected off of them was truly crazy beautiful! A good reminder that God was the first Artist...and the best One!

While I was SO tired after not being able to sleep more than 3 hours each night, I couldn’t go to bed early because I wanted to stay up and talk with my new friend from Nova Scotia. She is one of the most beautiful souls I have ever met, and we shared a kindred spirit!! It was so incredible to just be in the same presence together..sometimes talking, sometimes quiet, but always content!

Selfie with Monica (one of our team leaders, and also a precious soul) and Susannah

We shared our experiences of the past, the things we had seen God doing in the present, and our hopes for the future. It was an encouraging time. Often I have found that there are only a few people in our lives who can help to refuel our tanks and encourage our walk with Jesus that is life-giving. Susannah was one of those people! We say good bye to her tomorrow, as she is heading back to Nova Scotia after 7 weeks of mission work around El Salvador!

Enjoy a few more pictures from today and their captions below! Don't forget to click on the last image and listen to the great mission oriented worship song!!

Monica and Maribel (the mission house care-taker) with the biggest fresh pineapple I've ever seen!!

Thanks to WIFI, we learned how to communicate via Facebook video options. We were pretty bad at figuring out the ins-and-outs of it all, but we managed!

Aqua Fresca--cantaloupe style!

eating some fried pastries (Pasteles) that the church ladies prepared for us as a little snack before we left! They were little fried dumpling like foods with a hot piece of potato on the inside. They also had a fermented cabbage slaw that you kind of lump on it and eat all together/

brotherly love in all languages

sunset over San Salvador. We were above the clouds!