Bureaucratic tangles

Last week I had two brushes with Salvadoran bureaucracy that left me both crazed and awestruck.

Darren and I came out of a meeting at the Ministry of Health - I'd been pleased to find a place to park my car right in front of the building - to find a ticket on the windshield.  I saw that I'd parked by a yellow-painted curb, and down at the other end of the block was a small sign saying that parking was only available for official cars.  Ooops.  It had been raining and the ticket was soaked, so we put it to dry on the back seat.  A couple of stops later we noticed that the car no longer had license plates.  Our first and natural assumption was that they'd been stolen - a good possibility, as the Ministry of Health is in the historic center of town where thieves are said to abound.  Darren called a lawyer friend to ask how we should report this crime, and the lawyer asked if by chance we'd gotten a ticket.  Well.....yes.  And when we looked more closely, we discovered that the ticket - which was listing this parking mishap as the heaviest possible level of transportation crime and assessing a fine of $54, astronomical in Salvadoran terms - had a little checkmark noting that the plates had been removed.

So we called Darren's lawyer friend again and he sent us to an office of the transportation police.  When we got there, the guard at the gate refused to even let us enter; instead, he gave me a one-page paper telling me that I couldn't pay the fine and get my plates back for 24 hours.  I drove back to Suchitoto hoping I wouldn't have to explain myself, and then back into the capital the next day, 24 hours later, to pay the fine.  In Sertracen (where one pays fines and renews licenses) they happily took my $54 and told me to go around the building to the Vice-Ministry of Transportation Office to collect my license plates.  When I got there, the officials on hand looked at my paperwork and looked at their files and informed me that my plates were....somewhere else.  I would have to come back the next day.

And so I drove back to Suchitoto (this time at least I had paperwork to show I'd paid the fine, and a good thing too, as finally the police did stop me to ask why I was driving with no license plates) and back to Sertracen the next morning where I finally got the plates, but not the nuts and bolts that had held them on the car - those had apparently been discarded on site, or in someone's pocket.  I'm still trying to figure out why parking in a forbidden parking space is a crime more heinous than speeding (ticket of about $15 if I remember correctly, and no tinkering with the license plates) or any of the other really dangerous tricks that Salvadoran motorists get up to daily. 

That same day, after retrieving my plates, I went to the Migration office where I'd paid for my year's Residence Visa in January, but had yet to receive it.  I've had to purchase two 3-month temporary visas so I could leave and re-enter the country.  But the best moment in this particular bureaucratic hell was in August when the office called me to come in, and told me that I had to get a letter from the embassy to say that I am really who I say I am because the version of my name was slightly (very, very, very slightly) different in my birth certificate, my police check, and my passport.  Never mind that all three showed the exact same place and date of birth and that the difference was between Susan Vera Dewitt, Susan Vera De Witt, and Susan V. Dewitt.  Not only did I have to go to the embassy for a letter ("we see this all the time," they said, tiredly), I had to pay to have Salvadoran staff in a special little office not far from the embassy to put an apostille on my letter from the embassy to certify that it was genuine.  I had, of course, to pay for that, which may well have been the point. 

This time, in October, I didn't get past the front desk of the Migration office.  The receptionist kindly informed me that my card wasn't ready, and probably wouldn't be, and they were changing the whole process somehow, and things would be different next year, but meantime...meantime....

And then I went home, asked Alcides to attach my license plates, and tried very hard to stay peaceful.

Ready

That time of year again...

Our medical mission team arrives tomorrow, and at the last possible minute today (4:50 pm, to be exact) I got our franquicia (permission to import our medications and supplies without paying customs duties).  The franquicia is always a nail-biter, the essential part of our process that's pretty much out of our control once the papers have been handed over.  And I have to say that, like the good gringa I am, I really hate having to depend on something that's out of my control.  Illuminating, that.  As if my life or anyone else's was in my control!  But I do love the illusion.

And now, at last, the franquicia is in my hands, I've ironed the necessary shirts and slacks, I've checked my way through the long to-do list, I'm ready to meet the team at the airport tomorrow, and to introduce them to San José Villanueva on Sunday.

Meanwhile I'm enjoying the company of Margaret Gaffney, an Associate of the Sisters of St. Joseph of Peace, who's going to be part of the mission team.  Margie's been brushing up her medical Spanish in Guatemala for a few weeks, in preparation for helping with interpretation and came here on Thursday to help with the packing.  I've heard from Pat Clausen, who'll join us tomorrow at our retreat house lodgings and from Silvia Pleitez, who'll meet us at the airport, and from Hernan, our beloved motorist, who will be driving his new beige microbus to the airport tomorrow.

We're ready.

A week well spent

Sometimes in the last few weeks it looked as if our cataract surgery week would never happen. We hadn't registered as many patients as usual in San Rafael Cedros in February and half of the patients we registered didn't go to Hospital Cojutepeque for the required pre-surgery tests. One of our surgeons was unable to get the required Apostille (look it up on the internet!) for his license and curriculum vitae in time, and he couldn't come. The other surgeon mistakenly sent in last year's license, duly Apostilled, and I didn't even notice until the Medical Board called me. The paperwork for our franquisia (permission to import medications and supplies) was delayed in the Archdiocese because of a staffing change until too late. In the last couple of days before the mission team arrived on May 14th, it felt like a recipe for disaster.

Instead, it's been a wonderful and inspiring week, and a reminder to me that trust and patience are such necessary elements in this work. The hospital found us enough additional patients to keep our team busy each day of the week. The customs officers at the airport very kindly helped us find a way around the franquisia problem. And while we brought only one ophthalmologist, the amazing Dr. Tony Piscano (the Medical Board kindly said he could work as long as he had his current license with him), Dra. Ana Vilma de Burgos, a local ophthalmologist and our sponsor for SEE, International, worked with him for three of our five days. Our team performed 40 surgeries on 33 patients (we had a number who required more than one surgery). Our patients came away smiling, delighted with their new vision.

Our mission team had three Salvadoran members this time: Silvia Pleitez, a Salvadoran doctor now studying for a medical license in the U.S., has been on most of our mission trips; Rosy Melara, a recently retired scrub nurse, volunteered her time for the week; and Rosa Aguiar, a community organizer from Comasagua, joined us as patient coordinator for the third time. Here's Rosa wheeling a patient in for his post-op check.

I'm grateful to the Sisters and friends who responded to my urgent calls for prayer for this mission: as you can tell, they were abundantly answered. Thanks be to God!

Some days

Some days, my mother used to say, "you should have stood in bed." Yesterday was one of those. I went off to the capital to get my one-year visa from the estranjeria office and to take our request for permission to do a week of cataract surgeries (along with the required documentation) to the Junta Vigilancia de la Profesión Médica - the Medical Board. I waited an hour and a half at the estranjeria only to be told that my visa wasn't ready yet, though I'd been assured that it would be there right after the Easter holidays. Then I found out that the Junta Vigilancia had a new President - and my letter was addressed to the former President. Not possible to cross out one name and write the other: had to produce a new letter. I drove over to the Archdiocese to check in with Señor Duran, who is working on our customs approval, and - by that time - was not surprised that he was in a meeting and not available.

Then I went home, looking forward to a good shower and a peaceful night, and found that Suchitoto's water was turned off - apparently a pipe broke and had to be fixed. And we discovered that we had forgotten to fill a couple of jugs that we usually keep filled for just such emergencies, so we had only a small barrel of water to meet our needs. And then the electricity went off for about 2 hours. I should have stood in bed.

Today, I'm happy to say, has been much better: I had several good meetings, got the letters in to the Junta Vigilancia with the right person's name, even did a little cooking. And this evening the water came back on. Life looks possible again.

Eye surgery week begins

Getting our franquisia - to import our medications and equipment without paying customs duties - was more of a cliffhanger than ever, as the folk at Customs invented a new twist, requiring an extra seal and signature from the Archdiocese, and by the time we got back to the Archdiocese, those who could sign officially were nowhere to be found. Somehow Licenciada Angela Vasquez, who's charged with getting franquisias through the process, located a signator, and the papers are complete.

I don't know who has the main seal-and-stamp making business in El Salvador, but that would be a very prosperous enterprise here. Every organization has to have its seal, and every transaction has to be stamped, often multiple times.

Soon I'll be off to the airport to pick up our eight volunteers and Kathy Garcia. On Monday we'll begin our surgery week at Hospital San Rafael, in Santa Tecla. I'm told that the Centro Loyola, where we'll be staying during the week, has wireless internet available, so hope to be able to post some photos and stories.

Tramites update

I am delighted to say that Kathy Garcia and all our doctors pulled things together very quickly after the Junta Vigilancia de la Profesión Médica told us they wouldn't authorize our medical mission unless all the doctors' documents had an Apostille from their state. Licenses and Curriculum Vitae were re-notarized and sent to Kathy; Kathy took the Oregon documents to Salem for their apostille, and Andrea Nenzel drove the Washington documents from Bellevue to Olympia. Both sets were sent via Federal Express to our friends at CIS (Centro de Intercambio y Solidaridad) on Friday - because FedEx doesn't deliver to Suchitoto. I'll be lurking at the CIS offices Monday to get the precious apostilles and take them over to the . And at last, we should be properly approved!

Meanwhile work toward the February mission moves into high gear this coming week. There's a mountain of shopping to be done, meetings with our volunteers, complicated transportation issues to work out...a lot, but it all seems do-able and delightful. In two weeks we will have the clinics set up and organized, ready for Monday, Feb. 15th, when we open our doors to the people of San Juan Opico.

Tramites

The rhythms of a delightful week of family and sightseeing and visiting were interrupted by word from the Junta Vigilancia de la Profesión Médica. I had given the Junta - the group charged with approving all doctors in the country, whether visitors or residents - notarized licenses and curriculum vitae for all our doctors in mid-December. Now in mid-January, they announced that all the documents lacked an apostille, and that without this they would not approve our medical mission.

For those of you who've never had to get one, an apostille is an official document of the state - in this case Washington or Oregon - which certifies that the notary who notarized the licences and CVs is indeed a legitimate notary. It can be obtained quickly, while you wait, but the offices are in the state capitals, Olympia and Salem, and the licences and CVs would have to be gathered again and notarized again. The requirement for an apostille has been on the Junta's list of requirements for some time, but it's never been enforced before. But here we were with new leadership of the Junta Vigilanicia, and they intend to enforce every requirement. And it wasn't at all clear that we would have time to get the apostilles before our group arrived.

In a fairly frantic day in San Salvador, Dina Duvon and I pled our case at length to the Doctora in charge of our application. We had brought mission groups down here for nine years without ever getting an apostille, we said, and there had been no problem. The people of San Juan Opico were waiting for their chance to get a free consulta, we said. The apostille wouldn't give them any additional guarantees, we said, since the licenses are already instruments of the state and the notary has affirmed that they were presented by the person named in the license. But it didn't do any good. We would have to get apostilles. In phone calls back and forth to Kathy Garcia and other PeaceHealth staff, we figured we might be able to get it done, barely, if everyone hustled their documents over to a notary again and hustled them to Kathy again, and she drove them to the state office and sent them to me by rapid express. Dina and I wrote a letter to the Junta, asking that they allow the mission to go forward even if the apostilled documents can't be presented to the Junta - which meets once a week - first. And we asked the Archbishop of San Salvador to write a letter of support, which he most kindly did.

And that's where it stands. Kathy is hustling and I'm continuing with the organizing here, and we're pretty sure we will have everything together before our mission group arrives, but we'd ask for the good wishes and prayers of anyone reading this. As I've thought this over, I understand that the Junta Vigilancia wants to make sure that any group of doctors that comes here is really legitimate, that they fear, and reasonably so, that the people of El Salvador will get a raw deal from unlicensed doctors or out-of-date medicines. I wish they had been more open to compromise, and perhaps after the new leaders have been in office a little longer they will not be so intransigent.

But most of all, I desire the outcome that will be good for everyone: our group approved and providing health care to people in San Juan Opico who have little access to care. If it takes an apostille, we'll provide an apostille.

A change of address

I stopped by the bank today to give them my new address. No problem, a friendly clerk put the new address on the account. Oh, I said, and can you change the name on the account to my name? I'm already an authorized signer, and my checks say "Susan Dewitt / PazSalud." But the name on the account that's sent out every month is still Eleanor Gilmore. Oh no, said the clerk, that would require papers from an attorney... Or perhaps another six months for my Spanish to get good enough for sustained argument. It's always a challenge, operating outside the familiar boundaries of one's own culture, to guess what's going to be possible and what's going to be hard.

Names seem to persist here, whether the owners of the names are present or not. The electricity and water bills for this house come in the name of the long-deceased mother of the present landlady. When I call for a taxi to the airport, the taxi company tells me that I am Eleanor Gilmore (a reasonably challenging name for a Spanish speaker) and I have decided not to dispute that. I can be Eleanor Gilmore whenever that's the path of least resistance. Certainly, for the bank!

Baptism by fire

Saturday Hernan and I set off for the airport in Hernan's beautiful red coaster with an operating microscope and stand, a slit lamp (don't ask me what it does!), an autoclave (sterilizer), and boxes full of sterilized water, scrub soap, and snacks. We were on our way to pick up our crew of 8 for the coming week of cataract surgeries, and I got so preoccupied with all the preparations that I forgot to check the plane status. Folly! When we got to the airport, we soon found that the plane (normally due at 7:45 PM) had been delayed and was now scheduled for 11 PM. We settled down to wait, which is such an ongoing part of life in El Salvador, and I checked in with the airport authority police from time to time about whether and when they would let me go in to meet our passengers (and their baggage). I waved my set of franquisia papers around a lot - these allow us to import the medications we were bringing in without paying any customs duty, and I was of the opinion that it was going to make it easy to get our equipment and medications through customs. I was wrong.

The plane finally did arrive - at about 1 AM - and our group assembled at the customs line. I waved my franquisia again, and the customs agent started going through it with a fine tooth comb. He looked through the list, written in English (and already approved by the body that approves medicine imports), and wanted to know the translation for every term. Charo Sanchez from Bellingham, our interpreter for this mission, gamely went through the list as he made notes. Then he started looking up the medications on his computer. Then he told us that because we were bringing in anesthetics (the local anesthetics used to numb the eye for surgery), our import would have to be approved by the anti-narcotic division, but they were not at the airport at this hour (by now it was 2:30 AM), and furthermore the import would have to be approved by the anti-narcotics division chemist, and he only worked Monday through Friday, but maybe he would come in tomorrow to take a look at our anesthetics.

OK, we said, gritting our teeth (much toothgrinding going on), OK, keep the medications and we'll come back for them tomorrow, but let us take the rest of the things we need to have tomorrow to set up the operating room - the scrubs and patient gowns and sutures and eye patches and sterile gloves, and so on. No, he said, it's all on the one franquisia, so nothing in the whole shipment can be taken until it all has been approved.

We were a shell-shocked and completely exhausted bunch by now and it was clear that nothing was going to budge our customs agent, so we climbed wearily into Hernan's bus and went to the Hotel Novo, where a very sleepy looking night clerk let the group in at 3:30. I went back home and slept (blissfully) for four short hours.

We had managed to come away with a phone number and name to call the next day. When Charo called she talked to someone who said oh yes, no problem, everything's approved, come on down and get it. So Charo and Dra. Silvia Pleitez and I climbed on to Hernan's bus and rode down to the airport. The woman Charo had talked to said we didn't need to go to the Port Authority police to get permission to enter the Customs area - but we did. Another lengthy set of explanations, and we were back in customs, and the same customs agent was there, glumly filling out yet more forms. Can we pick the boxes up now? we said. It's going to be another 20 minutes, they said. Finally, after a half hour that felt like eternity, they had Charo sign her name on about 15 different pieces of paper, and they turned loose our equipment, and we loaded it into the bus and headed back to San Salvador.

Finally, today, we did get to the hospital, we did set up the surgery suite, we are ready for patients tomorrow - but I hope never to go through anything quite like the last 48 hours again. You can probably see the accumulated strain in the tired face of Charo, sitting on the right next to Silvia in the photo above. Behind them are the liberated boxes and duffel bags and tubes, taking up more than half of the coaster. Behind us, for this time anyway, is the customs office.

Naming

At last - after waiting a week and spending two hours doing more focused waiting in the Sertracen offices - I have a card that shows me, Dewitt, Susan Vera, as owner of the PazSalud car.

Easy to see how my name got scrambled. Any Spanish speaker looking at the name Susan Vera Dewitt would most likely assume that I was Vera de Witt, Susan - that my maiden name was Vera and my married name was Witt. That's how names are constructed in Spanish speaking countries: everyone carries two surnames. For men and unmarried women, those are the father's last name followed by the mother's last name. So because my father's name was Dewitt and my mother's name Hahn, I really should be, in a Spanish-speaking country, Susana Dewitt Hahn (and Dewitt is considered the main last name, el primer apellido). A married woman uses her father's name followed by de and her husband's name. So if I had married someone named Jones, I would be Susana Dewitt de Jones.

This difference in naming leads to endless confusion - the mixup of my name by the authorities at Sertracen, the mixup when Norteamericanos assume someone's mother-name is their real last name. Messes with your assumptions. A healthy thing, even if it leads to long, long waits in line.

An afternoon to forget and remember

A memorable, crazy afternoon. I set out about 2 PM to go to Sertracen - that's the private company that handles issues car titles and driver's licenses. I was hoping to get the card showing my title to our car (we couldn't put it in the name of PeaceHealth or the Sisters because neither has a legal status in El Salvador). This was my fourth trip, I think (they tend to blur together), and I was confident that it would be the last. I found a huge crowd when I went in with the number I was issued at the entry desk. The man sitting next to me told me that Salvadorans put off all their business until the end of the month and then come rushing in to get it done - which would mean that Salvador is not so unlike the U.S. I went from the first counter to the cashier, where I paid for the title, to the final counter where I would get the card. I got the card, and it said that the owner of the car was Vera, Dewitt Susan.

Now this is a natural mistake in Spanish. Anywhere in Latin America, most people have two last names, one from the father and one from the mother. But when I pointed out that my last name was not Vera, alas (it's my middle name), I was sent back to another counter where, finally at about 5:30 I was told that I could come back for a corrected title (I hope) next week. Meanwhile, I have the title card for Señora Vera, and am wondering if it would be simpler to just change my name.

I came home to the wonderful news that our new Congregational Leadership Team has been chosen, and it's a splendid group! I was e-mailing about it when the front doorbell rang. I rushed out to answer it, and found Freddy, who wanted Eleanor to know how happy he was with his new bifocals - he can see close up AND at a distance now! I told him I'd tell Eleanor, and turned around to discover the front door had slammed behind me. And there I was, locked into the front yard, between the double locked front gate and the locked front door, with my keys inside the house.

Francisco, our valiant guard, was right there. He figured out that the best way to rescue me was to get into the back yard, because I remembered that I hadn't (thank God!) locked the back door. So he borrowed two ladders - one tall and sturdy wood ladder, one short and rickety aluminum ladder. He passed the tall ladder over the front gate to me, and I set it up against the gate. Then he climbed the short ladder, threw a leg over the gate, and somehow managed to connect with the tall ladder on my side. Then he got a friend to pass the short ladder up to him, and he repeated the two-ladder exercise to climb over the razor wire into the back yard. And shortly I was back in the house, clutching my keys, from which I hope never to be separated again.

Francisco said it was nothing - after all, he was wounded by nine bullets in the war (he showed me most of the scars) and climbing a few walls was nothing after that. But it was a lot to me. It was feeling safe in a country that I still don't know very well. It was knowing that I might never get my tramites done, but I wouldn't be stranded between locked doors. Muchisimas gracias, Francisco - you are the kind face of El Salvador for me.

Law and injustice

I heard a sad story tonight about some vigilantes (guards) who hadn't been paid in three months because the woman who owned the guard service was in financial trouble. They've been showing up to work faithfully, hoping that something would work out, because it seems that even a job with three months' arrears in pay is better than no job here in El Salvador.

There are laws that require employers to pay their employees, and to pay social security, and to give their employees health coverage, and to give their employees an extra month's pay as a bonus in December. From what I can tell, El Salvador's laws in this and other areas are excellent. But they aren't enforced, and so they aren't followed. An employer who's reported to the the equivalent of the Labor Department might get a slap-on-the-wrist fine - I heard $50 was the likely sum - with no followup to see if the mistreatment of employees had stopped. This kind of law is like a pretty poster covering an ugly hole.

I'm reminded of the words of the English renaissance poet, Samuel Daniel, in an Epistle to the Lord Chief Justice of England (which I'm remembering by heart, probably not entirely accurately):

....even injustice may be regular
And no conjunction can there be betwixt
Our actions which in endless motion are
And the ordinances which are ever fixed.
Ten thousand laws more cannot go so far
But malice lives within and is enmixt
So close with justice that it ever will
Confine, confound and counterfeit her still.

Regular injustice seems to be a hallmark of life here.

Politics!

I haven't mentioned it yet, but the big topic in El Salvador now is the elections - coming this Sunday, Jan. 18th, the legislative and municipal elections, to be followed in March by the Presidential election. Everywhere in the country, this means that all the lampposts are covered by posters just showing the party identification - mostly ARENA (the conservative party) and FMLM (the party of the left). This is called pinta y pega according to the papers here - pinta for the signs and pega (I'm guessing here) because each sign is crossed through with a thick black marker by the opposite party almost as soon as it's put up. This causes fights and wild accusations that the other side is using gangs or urging its militants to commit crimes. Somewhere a printer is doing very well out of all this paper going on all these lampposts.

In San Salvador the mayoral contest is between the current FMLN Mayor, Violeta Menjivar, whose signs say Violeta Sigue (Violeta continues!) and the ARENA candidate, Norman Quijano (Seguridad, Orden, Limpieza - security, order, cleanliness). Not only are the signs everywhere, but there are parades, demonstrations, accusations and counter-accusations. The cartoon above comes from a little broadside published by Equipo Maiz and shows a happy FMLN crowd in full swing of demonstrations. I'll let you know what happens - that is, I should be able to let you know if TSE, the Bureau of Elections, manages to get its reporting and tabulating systems running. Sound familiar?

Trámites

Trámites means procedures, paperwork, going through official channels and today - after Eleanor and I put Andrea and Beth on the plane back to Seattle - was dedicated to trámites. I need to get a driver's license, transfer the title to our project car (a sturdy and faithful 1996 Toyota Forerunner) into my name, get my name on our bank statements, order new checks....and this was just the beginning. Thanks to our lawyer, Doctora Consuelo, our banker, Señor Paz, and the young woman who issued me an N.I.T. (No. de Identificacion Tributaria, which I think means something like Tax Identification Number) for the astonishing sum of 23 cents, I am well on the way to becoming a real person in the eyes of the Salvadoran government. What was best, and most astonishing to a Norteamericana, was the generosity and helpfulness of almost everyone we talked to. No one seemed to be rushing to the next task or project. Each person I met took account of my limited Spanish and made sure I understood what I needed to do.

And that's what I'm learning to love about El Salvador: relationships matter more than efficiency.