I’m writing this on Sunday, July 24, but I probably won’t be able to send it out for a while. The internet and phones have been down for several days and we don’t know when they’ll be working again. So I’m feeling a little cut off from the outside world. Then again, I spent two years in Guatemala with no clue what was going on outside of Central America, so I guess this is nothing new.
This week was more of the same. I did three more clinic days at the site at the stadium (Polideportivo) and an additional day at another clinic site at a school (Santiago). Santiago was great because it was located only yards away from a beach, so I got to walk on the sand and watch the waves crashing. The people there had built boxy houses with walls and roofs made of palm fronds all the way up to the sand. Possible natural disasters aside, not a bad place to live.
The families here have the same concerns that they did in Guatemala: my child isn’t eating enough, his stomach hurts, he gets headaches. Which is code for: can you give me vitamins and deworming pills? Of course, I’m glad to hand them out. I have this mental picture of me working in the ER once I get back to Baltimore and dismissing parents’ complaints by saying, “Just give her some vitamins and mebendazole. She’ll be fine!”
Of course, I’m trying to dig deeper, too. I’m finding lots of asthma here, just like I did in Guatemala, but it can be tricky. Every parent will tell you that their child coughs all the time, but often that just means that they cough every time they get a cold. We also see a number of kids with more complex medical conditions; they’ve had comprehensive evaluations in local hospitals, but their families can’t afford the medications or imaging that have been prescribed. One unfortunate kid I saw was a seven year old with imperforate anus who had a colostomy. The colostomy bags were irritating his skin, so he just has a cloth wrapped around his abdomen to serve as a diaper. He needs surgery to create an anus and take down his colostomy, but sadly we were not able to do it on the ship.
My favorite patients this week were 9 day old twins with cleft lips and palates. I admit, I complain a lot about newborns—especially preemies—because of their irritating habits, like stopping to breathe for what seems like no good reason. But I still go crazy over cute babies, and these two were adorable. They were there with their grandmother and aunt. The funny thing is that at first we all assumed the aunt, who was very petite, was the mother and that she looked amazing for having had twins just nine days before! The mom was actually at home recovering from a C-section. The twins did come aboard to be evaluated for a possible repair, but unfortunately they are simply too young to do the surgery right now. It was a big disappointment for us and the family. The good thing is that the family already has a good nipple for feeding the babies, who appear to be getting plenty of calories. I think they’ll do fine until they’re big enough for surgery.
We have had the chance to enjoy some local food and culture. Before I arrived in El Salvador, I knew that I didn’t want to leave without eating some pupusas. These are corn tortillas stuffed with beans, cheese, pork or other fillings then fried. They are served with hot sauce and shredded cabbage, and they are delicious. And when I say delicious, what I’m really saying is that they are one of the greatest foods ever invented by mankind. I think Satan could have tempted Eve with a plate of them. I was worried I maybe wouldn’t get any: we have been under heavy security in this country and have been restricted to the ship and our clinic sites. There is a big violence problem here, although most of it is gang-related. The people we have met, however, have been wonderful. In fact, a group was at Polideportivo one day giving out pupusas to show their gratitude to us. They even made them right on the site. You can bet that I was very grateful to them, too!
That same day, a local high school put on a cultural presentation for us. They had traditional dancing, accompanied by keyboard, guitar, drum, and two off-key recorders. The girls wore colorful, flowing dresses, and one poor boy had to dance along with all of them. The school choir also performed, and that turned out to be one of the unexpectedly moving moments of this mission. They sang Beethoven’s Ode to Joy, though with different lyrics in Spanish and accompanied by their music teacher on guitar. I couldn’t help but think of the original words in German and their message that all men are brothers. Here I was, in a small country in an often forgotten part of the world, listening to Beethoven. The kids may not even know who Beethoven was. The distance between nineteenth century Vienna and twenty-first century El Salvador, after all, is great. But while they sang, we were united by the hope written into Beethoven’s melody.
You know, I can’t solve many of the problems I find here. I don’t know how big of an impact I’m having, no matter how many starfish I throw back in the ocean. But moments like that remind me why I’m here.
Well, we leave for Costa Rica tonight. We’ll be at sea for a few days, then we’ll have liberty in Costa Rica. I hope you have a great week, and I’m already looking forward to sending out another dispatch soon!
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