A grand week

Our mission team loved their long, hot, busy, happy and productive week of medical and eye clinics in Estanzuelas.  We saw 1467 Estanzuelans, most for two or more clinics.  Our providers prescribed for those who needed medications - and everyone went away with vitamins and a toothbrush, at minimum.  We referred many patients for specialty treatment or diagnosis within the National Health System.  We signed up our full list for cataract or pterygium surgeries in April in the Hospital Nacional at Santiago de Maria.  More than 100 families are being invited to our capacitation session for receiving a water filter. 

But most of all, we carried away with us bright memories of faces and voices, people who touched our hearts, smiling or howling children, beautiful seniors, hardworking men and women.  

Here are a few images from the week, bright memories:

Sister Beth and interpreter Lea worked at getting just the right glasses for this patient.

Schellie was kept very busy with ear cleanings; a speech therapist, she's had expert training in ear lavage, and we used her skill to the full.

Interpreter Rita, Dr. Gulrukh and nurse Julie focused on this beautiful woman.

Dra. Jakellyne Jimenez, Director of the Estanzuelas Unidad de Salud (medical clinic) was our gracious hostess.

Marvin Hernandez (standing, center) coordinated all the local volunteers and kept everything running smoothly.  He's a superb organizer and a great leader - it was a delight to work with him.

Fatima and Wendy, two of the scholarship students who were our local volunteers, brought their intelligence and cheerfulness to every task.

Rosa and Hernan, two Salvadoran members of our team.  Rosa explains the eye surgery process to prospective patients, and Hernan drives us safely wherever we need to go.

And finally, here's the new Health Mission leadership team - Kathy Garcia and Darren Streff.  I am so happy to be turning over the work of in-country coordination to Darren, though I plan to continue to be involved.  Can't imagine better guides for this work! 

Clean water in the schools

During our February Medical Mission in San José Villanueva, Padre Mario Adin asked us to consider giving Sawyer water filters to each of the public and private schools in Villanueva.  We were delighted to say yes to his request, and today I went to Villanueva with Clelia Estrada of the Caritas office in the Archdiocese of San Salvador and Darren Streff, Maryknoll Lay Missioner to make good on our word.

We met with representatives from the schools and with Health Inspector Miguel Angel Cruz, who'll be doing follow-up to make sure the filters are being properly used and cleaned.  They were a great and very attentive group, watching carefully as Licendiado Cruz demonstrated how to drill a hole in the bucket for the filter connection:

It's hard work!  When I set up the water filter at our house, I was determined to manage the whole process myself, just to know that even a 70-year-old woman could put the filter and bucket together.  I did manage it - though much more slowly than Licenciado Cruz - at the cost of a sizable blister on my thumb. 

Several people wanted to know if it was possible to buy a water filter in El Salvador.  Not yet, I had to say, though I do hope that Sawyer Products will realize that they have a great untapped market in Central America.  Where did I find them in the U.S., and did people in the U.S. use them?  That question rocked me back on my heels for a moment, as I thought about the health gulf between us.  In the United States, filtering your water isn't necessary, though plenty of people do it.  The only place I've seen Sawyer filters in the U.S. is in sports stores, which feature the smaller filters hikers use.  The gulf is the difference between a country where water is purified and tested regularly, held to the highest standards of sanitation and a country where water is almost always contaminated by parasites, bacteria, amoebae, you name it.  Our few water filters only begin to touch the edges of this huge issue of justice.

Still, it's great to know that the schoolchildren of San José Villanueva will have clean water to drink! 

Buckets upon buckets

On Sunday it was time to give out water filters and buckets to the San José Villanueva families who'd fulfilled all the requirements (getting someone in the family tested for parasites and bringing $5 to cover half the cost of the water buckets).  I traveled out to the community with Iris Chacon (from San Rafael Cedros) who does an expert job of explaining the importance of clean water and how to use the water filters.  Darren Streff, a new Maryknoll lay missioner with a background in health care, also joined us - and got landed with the somewhat challenging job of hand-drilling the hole in the bucket (the water filter packets from Sawyer contain a small hand drill which works beautifully - but not quickly).  Here's Darren at work:

And here's Iris, teaching - my favorite of her stories was about a woman who said her filter was a bust, didn't work, couldn't get any water through it.  When Iris when to take a look, she found the woman had forgotten about cleaning the filter by back-flushing it and the filter was completely packed with mud.  Once cleaned, it worked like a charm.  Our participants - mostly mothers, many with several generations living at home - paid close attention.

The buckets, in the background, had all been previously used - mostly for Tang or some quite similar product from the smell - but will be washed out and converted into the bucket that receives water from the tap or the well.  The water is gravity-fed through the filter into a clean-water bucket that has a tap for drinking water.

All that talk about water - of course the inevitable happened, the clouds opened and water came pouring down from the skies, almost like a solid wall.  It rained buckets.  It rained cats and dogs.  And yes, we said, you can filter rainwater with the Sawyer system.  And then we put our papers and bags in one of the buckets and ran for the car.  Much of a good thing!

Feliz dia de San José

Happy St. Joseph's Day!  I've had a great double celebration of our community's patron saint.  Yesterday I took Kathy Garcia and Mitch Costin (they flew in Saturday night) out to San José Villanueva where we handed over twelve special prescription eyeglasses that were organized  by our February mission optician, Heather Downes, and made and donated by an optical lab.  Lots of happy eyeglass-wearing faces!  Then we helped out, a little, while Iris Chacon of San Rafael Cedros did a first workshop for the families who will be receiving one of the water filters we're donating, and we got a chance to exchange hugs with our San José friends.

Today was an even more special Dia de San José because I've had the great pleasure of watching while Mitch Costin of Eugene - a great stand-in for the saint - did an amazing lot of plumbing, carpentry, and electrical work to a) stabilize our operating microscope, b) fasten the handwashing sink firmly to the wall, c) install a toilet paper holder, d) put up a new lamp above the dishwashing sink, e) put up the new paper towel holder Donna gave me, f) re-hang all the mirrors at the right height and g) unstick my sticky kitchen table drawer.  This afternoon Mitch and Kathy and I went in and had a two-hour gambol through EPA, the new fancy hardware store here, that will lead to a few more things being done tomorrow.  We also bought a new super-sized toolbox to hold all the new and wonderful tools that Mitch has found for us so that our PazSalud toolbox is no longer a wussy and pathetic sight, full of curtain rods and odd lots of tape, but a proper manly St. Joseph sort of toolbox.  It was great fun!

On top of all that, Mitch took some wonderful photos - the two in this post are his.  Oh yes, and I began the day by teaching a computer class at the Centro Arte para la Paz with the help of Patti Moore and her Spanish teacher Beatriz, where the kids - ranging in age from about 11 to 18 - tore through the material I thought would take up two classes in the first hour.  St. Joseph come to my aid as I try to figure out what we'll do on Wednesday and oh yes, St. Joseph, a special blessing please for Mitch Costin who does your kind of work with such joy.

I woke up in Suchitoto this morning and it felt natural. The only things that kept waking me from time to time during the night were lemons dropping from the lemon tree onto the tin roof over my tiny bathroom (sounds VERY alarming) and a cricket that sounds all too much like my alarm clock - by tonight, I'll be tuning him? her? out. Didn't hear the cocks crowing or the morning buses going by, woke up to the sounds of the doves (and roosters).

I talked to a lot of friends this morning, and so far have found only one, our friend Armando, whose home and crops were seriously damaged in the torrential rains and floods of October. Suchitoto was spared the worst of these rains, though I'm sure all the roofs were leaking after ten days of rainfall. The damage is very visible in the roads here, and I would expect that they are far worse in parts of the country where the rains were heavier.

I also learned that one friend from this area is on her way to the United States, and I am praying that she will get safely through the grave dangers that migrants face in Guatemala and Mexico and will make it through the border, though I'm also very sad to think of the damage and loss her going causes for the family she left here. I wonder if people who get angry about illegal immigration into the United States ever think about how desperate people become because of lack of money and lack of opportunity in their own countries. I wonder what they would do in similar circumstances?

Instructions from a master teacher

When we finished our week of clinics in San Rafael Cedros last February, we gave 80 Sawyer Point One water filters to the community, in care of Iris Alas. Last week Iris invited me to a meeting at which she was handing over about 15 of the filters to women who had completed the necessary steps - they'd come to a first meeting where they had learned about the importance of clean water, and about how much it would save the family in medical costs, someone in the family had been tested for parasites and bacteria at the local health center, and they were ready to spend $5 or $10 (depending on means) to defray the cost of the buckets, which the municipality had purchased.

We met at Iris' house, and for the next hour I had the pleasure of watching a master teacher at work. First, Iris went over the details: starting the treatment for parasites once everyone in the family is using the clean water; using the clean water to wash hands and food; keeping the bucket of clean water covered and off the floor; sending the kids to school with bottles of clean water; making refrescos with clean water; backwashing the filter regularly to keep it clean. That's Iris at right in the top photo, and also in that photo, because I couldn't resist, is the family cat, occupying, like every good cat, the exact center of the space. Everyone, I'm here to tell you, carefully walked around the cat, who took this as her due.

Then three CIS volunteers showed how to put the filter and buckets together, and we watched the tap water flow into the bottom bucket, and then each of the women handed over her family member's lab test and the money, and each received two buckets and the filter kit.

It was a joy to see this being done so carefully because, as Iris says, otherwise the filters wouldn't be well used, or they might be sold or be forgotten. These women had to go through some work and pay some money to get their filters, and because of that they're much likelier to use them for the health of their families - and Iris and the local youth who get scholarships from CIS will be checking up in six months.

Ojala que llueve

¡Ojalá que llueve! - if only it would rain! That's how we're all feeling now at the end of the dry season as it gets hotter and hotter and hotter, with no rains to provide a bit of divine air-conditioning. The water around is coming out of our bodies instead: it's hard to drink enough to replenish what I'm sweating out. I'll confess that these temperatures have made it really pleasant to get into the project car (air-conditioned) and drive to the city to make those last-minute preparations for our surgery group, arriving on Saturday for a week of cataract surgeries at the almost-new and very welcoming Hospital Nacional de Cojutepeque. That's the national hospital for Cuscatlán, the departamento we live in.

¡Ojalá que llueve! I love this phrase because it recalls the time, centuries ago, when Spain was a Moslem country. Ojalá was a petition to God, O Allah, and is one of many Arabic words that are inextricably woven into the Spanish language. I'd also want to say tonight "¡Ojalá que todo vaya bien con nuestra misión!" - may all go well with our mission, with the group and their work next week for the people of Cuscatlán.

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.

Water filter does its job

In early May, we brought a Sawyer Water Filter to the San Juan Opico village of Los Granadillas, where it's been well used. The woman who has housed the filter reports that when she backwashed it to clean it, a lot of mud came out of the filter, and everyone said: we used to drink that! Worse than the mud, of course, were the invisible creatures, bacteria, amoeba, parasites, that are also being filtered out.

This week we got the results of a microbial analysis of the water, comparing the filtered water to the tap water residents used to drink. It was just what we hoped to see: the tap water had 110 coliform bacteria per 100 mililiters, the filter had none. And the community is enjoying their clean water, finding the system easy to use.

We've now ordered another 30 filters, and are going to be fund-raising to purchase more for Salvador communities - be forewarned!

Red Alert

Over the past six days El Salvador has gone from a green alert - Wednesday - to orange - Friday - and today to a red alert. So much rain has fallen that all the country is super-saturated. Rivers are overflowing. Villages are cut off. The new fields of just-planted corn are washed away. Six days of torrents, six days without sunshine - we're living in the back-wash of Agatha, the first named Pacific tropical storm of the season.

At least this week there was time to evacuate villages in danger and to help people cross the raging rivers (see the photo from La Prensa Grafica). Some lives have been lost - I think I heard of seven fatalities - but many less than in last November, when a month's worth of rain fell in one terrible night.

Here in Suchitoto, we're doing OK, but more than a little damp. When you wash something out in this weather, 100% humidity, it just stays damp. Saltshakers clog. The drainpipe above our washing machine is leaking copiously. Small problems, indeed. Our spirits have been lifted today because we were invited to share the Trinity Sunday Eucharist with a visiting Jesuit and students from Canisius College in Buffalo, NY (they've spent their whole week here in the rain and the mud, and still seemed to be loving it). We're also hopeful because it hasn't rained in Suchitoto for about 10 hours and maybe, just maybe, the weather is going to change. Primero Dios!

Clean water for Las Granadillas

During our February Medical Mission I spent a day translating for Dr. Anne Welch, one of our excellent pedia-tricians. We saw family after family where the baby at breast was round and rosy, but the children who were no longer nursing were thin, pale and listless. Anne diagnosed likely cases of parasites or water-born bacteria, and it made her mad. Why didn't these families have access to clean, safe drinking water? She told the Mayor of San Juan Opico how important it would be to improve the water systems. Clean water is hard to come by in El Salvador generally, not just in Opico, and the children are the ones who suffer most. I came away wanting to find something we in PeaceHealth could do to help families with this basic need.

When I came back to Bellevue, WA in March, I talked to Sr. Andrea Nenzel about the need for clean water in Salvadoran communities. In one of God's minor miracles , she had just heard about Sawyer Water Filters and encouraged me to look them up. I was impressed with what I read about them and ordered one for a trial. Dina Dubon de Garcia, a longtime friend of the CSJP community and our main contact for San Juan Opico, tried out the filter in her house and discovered that it worked well, filling a 5 gallon jug in about 20 minutes.

Today we took the filter to the community of Las Granadillas, located in a coffee finca in the hills at the southern end of the San Juan Opico municipality. Dina and Reyna, the local health promoter, called together a group for training, or "capacitacion," as it's called here, and did a magnificent job of community education. People in the group knew that you could clean the water by boiling it, but, they said, it didn't taste right after being boiled. They were curious to learn how this system new operates - and how the water would taste.

It's a very easy-to-understand and easy-to-follow system, using gravity flow to pull dirty water from an upper bucket through the small filter into a lower, clean water bucket. The Sawyer filters are cleaned by back-washing when they get full of gunk, and are guaranteed for 1 million gallons, enough to last a community for quite a good long time. It filters out bacteria, protozoa and cysts, filters water fast enough to be used by a small community, and the price is quite reasonable.

Dina showed the community how the system is assembled, and we were ready for the first test: water from the community tank was poured into the top bucket, and quickly passed through the filter into the bottom bucket. And then we all took a drink of the clean, fresh water, and everyone said it tasted just the way water should taste: "rica," said one man, the ultimate compliment for food or drink here.

They decided where the system will be placed and which family would be responsible for back-washing the filter. We'll be following up with a test of the filtered water and gathering the experience of the Las Granadillas community as they use the filter. And if it works, as we hope it will, we plan to provide more filters for more of the communities in San Juan Opico, thanks to the generosity of our donors. It's been a happy day.

Summer

The terrible rains and flooding of this past weekend have left so many families grieving and homeless, so many communities isolated, so many crops lost. I remember Eleanor Gilmore saying that the last rains of winter, the rainy season, were often the worst, and this was the worst of the worst.

Winter has now given way to summer, the dry season. Skies are blue all day, and it's the coolest time of the year, relatively speaking - nighttime temperatures go down to about 70, and it's about 82 at midafternoon, very pleasant. Families gather on the plaza in the afternoon, and everyone enjoys the evenings. It's usually a time of celebrations and fiestas, but the floods have cast a long shadow over our pleasures.

Pat and I went down the steep street to the lake yesterday and watched the lanchas maneuvering through the thick growth of water hyacinth at the Puerto San Juan, with the boatmen using machetes to cut a way for the boats. At least we think it's water hyacinth, after consulting on-line resources. Here it's known as lechuga, lettuce, or nimfa. This lake, created by a dam on the Rio Lempa in the 1950s, is heavily polluted. We're told not to even think about swimming or eating any fish caught in the lake. So perhaps the water hyacinth, although it's an invasive introduced species, does bring some benefits: it's efficient at taking up heavy metals and other pollutants. No wonder it's doing so well on Lago Suchitlan.

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.