San Cristobal

Here are a couple of photos (Above: Ken Henderson, Rosa Mejia, Kathy Garcia, Susan, Padre Orlando. Below: Ken, Padre Orlando, Kathy) from our visit last Friday to San Cristobal, a municipality in the Cuscatlan department. We drove out with Mercedes Tejada, who works with San Cristobal on behalf of the Archdiocese of San Salvador's Pastoral Social program. We met with Padre Orlando Erazo, with a couple of the parish's coordinators - both named Rosa, and with the Director of the local Unidad de Salud health clinic.

San Cristobal couldn't be more different from bustling, semiurban San Juan Opico, our other possibility for next year's general medical mission. It's very rural - most people in San Cristobal are making their living from agriculture or micro-businesses - and it's a small community. San Cristobal itself - the central town - is not large enough to support its own mercado, so residents must go to the nearby city of Cojutepeque to do their shopping.

Health and environmental issues and problems of access loom large here. Padre Orlando said he would like to find a solution for the water contamination that contributes to poor health. Infant and childhood mortality is above average here, perhaps both because of water and food contamination and the difficulty of getting into the central community from the rough dirt roads of the outlying colonias.

We experienced one of these roads driving to Santa Anita, the furthest village in the municipality, to see the beautiful little health clinic that was recently built there with help from the Spanish government. A doctor comes out once a week, and local health promoters work with the people at other times; a welcome change, I'd guess, from having to bounce over stones and through mud in the trucks that provide Santa Anita's only transportation.

An alarming day

Last night the lights went out for about six hours during a thunderstorm, and Margaret Jane, Kathy Garcia, Ken Henderson and I crept around with candles and flashlights. This morning, with the lights restored, there was a knock on the door, and there was Hernan Merino, whose coaster has been the transportation for almost all of our mission groups. We were heading to the airport, and he was taking a group of Spaniards to the airport about an hour later. We had a great visit, then Margaret Jane and I got in the car to take Kathy and Ken to the airport. As we were driving out of Suchitoto, the security system malfunctioned, and the car stopped, howling about how it was being stolen. A little work, trial and error and waiting until the howling stopped, and we managed to get it started again.

Half an hour down the road, we came to San Martin, and found the usual path to the Carretera de Oro (the golden highway, so called because of its high cost) blocked by a parade and fiesta - and slowly, very, very slowly, made it through a number of unmarked detours to the highway. I may have pushed the speed limit a bit from there, so we arrived at the airport in good time for their flight.

And then, as we were driving out of the airport, it happened again. The button that's supposed to disarm the car alarm wasn't functioning. The car hooted, beeped, and when all my button pushing didn't connect, it stopped on the exit from the airport and howled and went dead and refused to start again. We tried everything, and nothing worked. The airport police came to see what was the matter, and came back with a policeman who they said was really good at these things. He tried. Nothing. A nice man stopped his car to help us. Nothing. We called Hernan, who was just leaving his group at the airport, and he parked his coaster behind the Toyota and tried everything he could think of. Nothing. Finally he called his brother who suggested calling a locksmith, and the locksmith came dashing down from Mejicanos (a San Salvador suburb), and dismantled the alarm. Should he just take it all out? he asked - Oh yes, I said, please get rid of it. So he did, as Margaret Jane and Hernan and I shared water and the shade of the trees. And after about 3 hours on the side of the airport road, we finally were able to start the drive back to Suchitoto.

What was grand in all this was the helpfulness that I've learned is so easily found in El Salvador - and the police and the man who stopped and Hernan and the mechanic all played a part in putting us back on the road again, this time with a voiceless car.

Prayers for Paula and Alex

Paula and Alex Alvarenga are in need of your prayers. Paula is about 7 months pregnant with their first child, and will be going into the hospital tomorrow because of high blood pressure and - I think - gestational diabetes. I've been asked to be their son's godmother, madrina, so this is also my family. Please pray for Paula to be well and for a safe delivery.

San Juan Opico

Yesterday Kathy, Ken and I picked up Dina at the Arzobispado offices and drove out to San Juan Opico, a potential site for next year's general medical mission. Dina, who has been working with the Archdiocese of San Salvador for 25 years, knows our Sisters of St. Joseph of Peace well - she worked closely with Andrea Nenzel and Margaret Jane Kling when they were accompanying the people who went to the Calle Real refugee camp.

Now Dina works with San Juan Opico and Ciudad Arce in the Pastoral Social - the social services wing of the Archdiocese - promoting better health care, better social services, and environmental awareness. Environmental awareness is a key issue in San Juan Opico (located northwest of San Salvador) because a local battery manufacturer allowed toxic materials to pollute groundwater and earth near its factory, causing lead poisoning in a number of families who lived nearby. The factory is closed now, but the pollution continues.

San Juan Opico is a big, lively city with over 90 associated communities in its municipality. We met with Padre Miguel, the doctor who runs the local Unidad de Salud clinic, and a number of health promoters who would be our key connection to the smaller communities. We toured a couple of potential clinic locations - in the photo above, Dina (left) shows Kathy, Ken, and Carmen, one of the health promoters, one possibility.

Today we'll be visiting San Cristobal, the other community that's been recommended for next year's mission.

Lost in customs

On Monday night Kathy Garcia and Ken Henderson flew in from Seattle to the San Salvador airport. Kathy is our PazSalud program manager and Ken, a retired optometrist, passionate sailor and Lions Club member, has been the driving power behind our eye clinics. They're here for a week that will include selection of the site for our February, 2010 general medical mission and the presentation of an A-Scan machine to San Rafael Hospital by the Bellingham and Salvadoran Lions Clubs. At least we hope the week will include that presentation, but right now the A-Scan and other medical donations for our missions are stuck in customs, yet once again. The Salvadoran Lions are working hard to get the donations released in time for a Friday ceremony.

Meanwhile we have been sorting through the tubs of equipment for the medical mission and then, today, we heard of the death of Senator Edward Kennedy and followed the stories of his life on CNN-Español and through the NY Times on-line. It seems particularly sad that he will not be in the Senate to prod and cajole passage of the health care bills. I hope his death will give new urgency to the need for passing a good and durable health care bill.

The students

This is Crisseyda, my computer student and Spanish teacher. She's 11 and lives just down the street in Suchitoto, and she loves learning how to use a computer - in her school, there aren't very many computers and each student just gets a few minutes on one once in a while. So Crisseyda and I have explored the basics - turning the computer on and off, opening a program, writing a few sentences in Word. Right now Crisseyda's learning touch typing (OK, keyboarding, I learned in another era) from a cheerful program, the Ten Thumbs Typing Tutor. It's all been fun to experience with her, and our conversation is very good for my Spanish. We're acquiring a useful vocabulary of computer words in both languages. For me, it's good to be a teacher again - and a learner always.

A subject of some delicacy

...and the cause of a great deal of cultural misunderstanding:

What do you do with a used hunk of toilet paper?

If you're a U.S. or Canadian North American, you throw it in the toilet.

If you're a Mexican or Central American (or South American??), you throw it in the wastebasket that is carefully placed next to the toilet. If the wastebasket isn't there, you may throw it on the floor. Any place but the toilet.

Why? The drains here have much smaller dimensions than in the U.S./Canada, and toilet paper very quickly clogs them. [Later note: Sheila McShane, who runs a health clinic in Guatemala, reminded me that any drains at all are a bit of a luxury in Latin America - in the countryside toilets may flush, but the contents will end up in the river.] Latinos well understand how frustrating it is to deal with a clogged toilet, and considerately, carefully will place toilet paper elsewhere.

When Latinos follow their considerate and careful customs in the United States, North Americans are appalled at having to pick up the mess. When North Americans follow their healthful and hygienic customs and throw toilet paper in the toilet in Latin America, their hosts are appalled at having to pay for a plumber to get their drains working again.

And it all comes down to the practical necessities caused by drains of different sizes.

Hilda

I had a great visit today with Hilda Calles Nuñez, a community organizer and single mother of six who lives in the village of Huisisilapa (took me quite a while to learn to spell and pronounce that, but Hilda says I've got it right now).

Hilda has received wonderful support over the years from a group of PeaceHealth volunteers who wanted to make it possible for some of her children to go to college. She told me today, with understandable pride, that one son is about to graduate with a teaching degree and another is studying for the licenciate in sociology. Three other children have graduated from high school - in itself a considerable accomplishment in rural El Salvador - and one wants to continue at the university. Her youngest daughter is in 9th grade and will soon be studying for the Bachilerato (equivalent to a high school diploma).

Two of the grown children are working, one in the family fields, but don't make much income. Hilda has worked for a rural development organization call UCRES (sorry, I don't remember what that stands for) for sixteen years, but like many in non-profit organizations around the world, she has been laid off as funding dwindled. She's looking for work, she says, but meanwhile she has been selling milk (but the cows aren't yielding much this year, and the farmer has cut back the amount she receives). She buys medicines wholesale, sells some, and gives them free to those who can't afford to pay. She has a milpa and some hens. She sells extra corn and beans, keeping enough to feed her large family through the year.

With all of this going on in her life, Hilda is coordinator for Huisisilapa's chapel and in charge of catechesis and she's been studying the Pastoral de la Tierra - learning ways to restore the land and the communities who depend on the land. She's implementing some of that in her own house, planting chiles and huisquil (it's unique - looks like a pear, has about the consistency and flavor of a zucchini and is beloved here) to add a little extra nutrition and variety to the corn and beans that are her family's staples.

I've visited Hilda at home, where there are 10 or more family members living in her house at any given time and the inside is mostly beds. But outside, along with the corn and beans and chiles and huisquil, are beautiful flowers, lovingly grown in small pots.

I'm in awe of the burden Hilda has carried for so many years, of her daily hard work, of her determination that her children will be educated, and of her dedication to her community. And I am so glad for the flowers.

Home from Home

When I came into the El Salvador airport today, the immigration officer - after checking my residency permit - welcomed me to my second home. I'm delighted to have two places - my room at St. Mary-on-the-Lake in Bellevue and the house here in Suchitoto - which feel like home to me. It was good to be home for a couple of weeks to see family, friends and community, and it was good to be welcomed to my second home by Margaret Jane and Peggy.

Seashores

My sister Kathy and I returned from Eugene to Seattle the long and beautiful way, driving along the Oregon coast from Florence to Astoria, stopping to visit the sea lion caves (full of large lounging sea lions), to climb up to the Heceta Head lighthouse, and to walk the beach. It's my second long day by the Pacific within the past month: the other was at the beach pictured at top, in El Zonte, El Salvador. Thanks to Patti Moore for the El Zonte photo, which shows the grass-thatched huts and palm trees of a tropical Pacific fantasy. Heceta Head lies close to 44 degrees of latitude; El Zonte at 13 degrees, 30 minutes and the same ocean pushes and pulls at the shore in each place, the same gray whales go swimming by.

Thanks be to God for oceans and ocean shores, for the intimate connections of salty blood and salty ocean, heartbeat and wavebeat, water and ground.

Up the MacKenzie River

On Thursday afternoon we were treated to a memorable trip up the MacKenzie River with the Garcia family - Kathy, our PazSalud program manager, her husband Victor and their daughter Andrea. It was raining, but after all, this is the Northwest, and the rain felt familiar, gentle and cool - wholly unlike rain in El Salvador. We stopped at a fish hatchery to see a pond full of lucky rainbow trout - the ones who got chosen to live their lives in this pond free from anglers - and enormous sturgeon. Then the road wound up through forests of Douglas fir, hemlock and cedar until we reached the beautiful Sahalie falls, where the MacKenzie crashes over rock. And on the way back, we stopped at a roadside inn for pizza. I should probably mention that Kathy Garcia and I did spend the morning working hard on our program, but I know that this afternoon in the mountains was a special treat for the other Kathy - my sister - and me.

Recycling Health

On our way to a few days in Oregon, my sister Kathy Roben and I stopped in Lacey to visit CHUMA, Catholic Health United for Medical Assistance, where we met with Mark Koenig, System Director for Providence Health International and Ray Reyes, Manager for CHUMA International (Photo, left to right: Mark, Pete, Ray and Kevin, the CHUMA stalwarts).

CHUMA is a big warehouse of donated medical supplies and equipment ranging from elastic bandages to surgical drapes to staple extractors. These supplies, mostly donated from hospitals and healthcare systems, are sorted, packed and sent out to health programs in developing countries, including El Salvador, Honduras, Haiti, Cuba and Tanzania, where they will be well used to serve patients in need.

While CHUMA normally does not receive or process medications, they have made an exception for PazSalud; they've taken in shipments of medications from the Catholic Medical Missions Board (CMMB), have prepared them in plastic tubs for our mission trips, and have delivered them to our SeaTac hotel the night before the mission group travels. They are great partners, and I was so glad to meet them and get a tour of their impressive operation.