Thursday, November 16, 2017

The Right to Water

"They shut off my water.  We have no water in the house."

Three generations of adults and children, including a newborn and a few others under age 2 live in the house -- maybe 19 or 20 people -- all with no water.  No water for drinking or cooking.  No water for bathing or washing clothes.  No water for sprinkling on the floor to hold down the dust or on the plants so they produce fruits.  No water.

"I have a debt.  Finally they shut off the water.  I don't know in what way I will ever be able to pay this debt.  Everything fell apart all at once.  I don't know how we will resolve this situation."

The water system in the community is owned and operated by ANDA, the public water utility in El Salvador.  Water is metered and bills are sent out on a monthly basis.  Most people go to local banks to pay their water bills in person. 

The debt is more than $400.  The water source is a spigot at the corner of the tiny lot.  The family fills a 50-gallon drum and uses water one small bucketful at a time.  Even with multiple families living under one roof, it seems impossible that a household with a pit toilet and with no sink and no shower could use that much water. 

This water story began with a bill of $75 or $80.  (An average bill might be more in the neighborhood of $2 to $5 in a month.) The homeowner, a single mother and matriarch of the clan, filed complaints that the numbers on the bill did not match the numbers on the meter.  She filed a complaint in person which produced the response:  pay your bill.  Someone came out to the house twice and verified that the numbers on the meter and the bill do not match, but said the bills had to be correct.  Interest piled up.  Interest has been charged on interest.  The homeowner was told she cannot even file another complaint until she pays the minimum amount, about $100.

How does this happen?

A big agency like ANDA apparently has sub-contracts with a company of meter-readers.  Because they are sub-contracted, the meter-readers do not actually report to ANDA, and, according to my source (who is not the homeowner), they are often lazy.  They go out to work and do not bother to actually read the meters.  They read a few and then punch in the same numbers for every house on the street.  In the case of a community like the one in which the family in this story lives, the reputation of the community as "dangerous" is enough to convince meter-readers not to go there at all.  They either make up numbers or charge for the same amount of water each month based on some previous bill. 

To file a complaint requires taking off from work, traveling by bus, standing in line and being humiliated by a person at a big desk (again, according to my source).  This takes half a day.

The matriarch, her children and her grandchildren are currently borrowing water from a neighbor.  Back in the old days, they might have gotten water from a nearby river or a community well*, but the river is highly contaminated (because the gray-water system in the community was never completed) and the community wells were capped by ANDA when the municipal system went in. 

If the situation is resolved, and water is restored to the home, on the first day of each month the family will take a cell phone photo of the meter.  They will keep their own, clear evidence of the numbers. 

How will the situation be resolved?  The plan is to raise enough money to pay the minimum balance and restore water to the home.  Then a complaint will be filed again.  Apparently ANDA intermittently offers interest forgiveness days, which will mean standing in a long line at the bank, but might definitely be worth the hours-long wait.

The human right to water and sanitation. On 28 July 2010, through Resolution 64/292, the United Nations General Assembly explicitly recognized the human right to water and sanitation and acknowledged that clean drinking water and sanitation are essential to the realisation of all human rights.     (UNDESA)

*This link will take you to a story about the history of the water system in this community.  At the time that the municipal system was installed, the community was engaged in a heated debate about the right for people to have free access to water. In the end, meters were installed so that people would pay a fair and affordable price for the water they consume. 

To find other stories in this blog about water, try putting agua or water in the search box or click on the water in the list of labels.

Taken during a water march in San Salvador in June 2016

Thursday, November 9, 2017

Salt and Light

On November 16, 1989, six Jesuit priests, their housekeeper and her daughter were brutally shot to death by an assassination squad of the Salvadoran military.  Each year, on or around that date, a vigil of remembrance is held at the UCA (University of Central America in San Salvador).  Early in the morning, student groups from several universities, religious groups and social organizations send small teams of artists to the streets of the UCA campus where they begin to create colorful alfombras (carpets).  Using tinted salt and following paper sketches, the teams work their magic.  Each carpet is different.  Each carpet shares a message of faith, hope, love, reconciliation or peace.  By 4:00 PM most of the carpets are complete, and visitors begin to tiptoe around the edges, pondering the messages, taking photos, and admiring the beauty created in memory of an evil, ugly event.  As the sun goes down, the colors of the carpets fade to gray.  Later in the evening, candles will once again gently bring the colors of the carpets to life as pilgrims walk upon them.  The colors streak then blend until the designs are lost under the feet of pilgrims.  Despite the brevity of their existence, the images of light and hope shine brightly, like candles, like a mother and a daughter, like teachers, like priests, like those who cry out for justice, like those who work for good, like saints. 

These photos were taken prior to the vigil at the UCA
in November, 2016.  The roses in this carpet are remeniscent
of the roses which grow in the garden, where the bodies
of the Jesuits were found.

You are the salt of the earth.
You are the light of the world.

Sunday, November 5, 2017

Days of Saints and The Dead

Claim your saintly identity with each step on your path.

The Grandfather whispered these words in my ear during the passing of the peace.  The Grandfather was reiterating the message of the Bishop's sermon - what we believe is what the Apostle Paul writes in his letters:  sainthood comes in baptism.  We belong to God's kingdom now, and we live full, fruitful lives when we live in God's way right now.  Some day we will be laid out dead in a church and people will remember us, but we don't wait until that moment to claim our sainthood. 

Today we celebrated All Saints Day in the Salvadoran Lutheran Church.  Today we remembered our loved ones, the saints who have gone beyond this short life into the long life of eternity.  Today we honored the saints who lived inspirational lives of faith and who, like the Lutheran pastors Francisco and Jesusita, lost their lives because of their Godly work. 

Día de los Muertos celebration with Aztec dancers (USA)
Depending on our religious traditions and our cultures, we celebrate All Saints Day in different ways.  In the US, we might know the history of All Hallow's Eve (Halloween) and All Hallows Day (or All Saints Day).  If we come from a Roman Catholic background, we might also know about All Souls Day.  In many places such as in my home city in the US, churches and community groups are working together to build stronger intercultural relationships, so that celebrating el Día de los Muertos (Day of the Dead) brings local indigenous culture together with cultures of native peoples from throughout the Americas together with Christian celebrations.  In general, we can say that many US Christians recognize the days of the saints as a time of year in which to honor and remember the lives of loved ones who have died and to specially recognize and hold up those great role models of faith who inspire and guide us.

In El Salvador, the celebrations surrounding All Saints Day are much more widely practiced than in the United States.  Families dedicate time inside and outside of church to honor their deceased loved ones and spend time together.

From El Diaro de Hoy
In Tonacatepeque, the saints days festivities begin with the Fiesta de la CalabiuzaThis year, the festival was held on November 1st.  The festival celebrates the local legends and mysteries which have been handed down through generations of campesinos.  (If you click on the "legends" label to your right, you can find various stories which I have transcribed and translated over the years.)  Due to a flight delay, we missed out on this year's festival, but a quick visit to the town's Facebook page took me to some good photos, videos and news reports of this year's events.  Apparently the town used more than 500 pumpkins to make the traditional "pumpkin in honey" treat that everyone eats after the parade.

Plastic garlands on a couple of our altars from our US
Day of the Dead celebration - I learned how to make
these a few years ago from some women in Tonacatepeque.
November 1st is All Saints Day.  Historically this was a day in the Roman Catholic Church celebrated in honor of those who had been declared saints by the church.  Now this celebration has mostly been relegated to a Sunday celebration. 

In El Salvador, November 2nd is the Día de los Muertos or Día de los Difuntos (Day of the Dead or Deceased).  Traditionally, this was a day on which families prayed for their loved ones who had died but were not yet in the presence of God, and for some this remains a strong tradition.  November 2nd is an official government holiday.  Offices and schools are closed.  Because this year Día de los Muertos fell on a Thursday, we observed that schools were also not in session on Friday, November 3rd.  The Days of the Dead bring families to the cemeteries, where they clean and decorate the tombs of their loved ones.  Many of the families use plastic flowers, pinwheels and plastic garlands as grave decorations which will last until Christmas.  Sometimes a family will bring food and music (perhaps a mariachi group) into the graveyard and share a sort of picnic beside their loved ones. 

As cultures from North, Central and South America increasingly intersect, traditions evolve and grow.  We are certainly richer, I think, when we can share each other's stories, histories and traditions.  It is important not to make assumptions, such as equating the Fiesta de la Calabiuza with Halloween (which comes from an Anglo-Saxon tradition, and not Central America), nor to draw broad generalizations about any culture.

A photo taken today in the US at a
Lutheran Church (credit to Pastor Eric)
As the names of deceased loved ones were read during worship at the Lutheran Church today, candles were placed on the floor in the shape of a cross.  The Bishop reminded us that if we feel like crying, we should cry.  If we feel like laughing, we should laugh.  We are saints and we are not perfect, and we have each other.  And while we surely should never abandon the graves of our loved ones, we are wise to spend the days of the dead with the saints who are still walking in this life. 

These are the days of the saints and of the dead.  So begins November, the month of the martyrs.  In El Salvador, November is a month of remembering and giving thanks for those who have taught us how to claim our sainthood as we take each step on our path in this short life on earth.

Wednesday, November 1, 2017

Antifaz Fun

The word for mask in Spanish is máscara.  This word is rooted in Arabic and relates to the idea of something false or hidden.  I recently learned that máscara is the word used for a mask that covers the entire face, and is made of plastic or paper maché.  There is a second Spanish word for mask, which is antifaz.  This word literally means "in front of the face" and is used for the kind of mask that covers the eyes.  Your favorite superhero or masquerade ball attendee might wear an antifaz.

You can find inexpensive antifaz masks at many craft stores or online for a very reasonable price, and if you happen to travel to El Salvador at Halloween, you might like to consider decorating these masks with little ones or adults.  Depending on the type of paper, you may need to use permanent markers.  Adults surely would enjoy adding sequins and feathers, so don't forget to pack the tacky glue.

Sunday, October 15, 2017

Days for Girls in El Salvador - Women Working for Good

A small group of women are gathered in pretty purple house.  For a while it is quiet, except for the whirrr of a few sewing machines.  Then someone makes a joke and the room erupts in laughter.  Outside the house, thunder rolls and big raindrops begin to fall with loud plops onto the leaves of banana, mango, lime, and cashew trees.  Soon the laughter and the sewing machines are equally drowned out by the loud roar of a heavy downpour on the metal roof.  Everyone goes back to work.

Sewing in the pretty purple Women's House
This is a story of determination.  This is a story of community.  This is a story of creativity.  This is a story of women working together in support of one another across boundaries, across cultures and across languages.  This is a story which began with a need for girls and women to have good information about their bodies, which led to a connection with Days for Girls International, which led to giving away more than 400 Days for Girls kits, and which has birthed a sustainability project for women in a small Salvadoran community.  And although I did not plan for any this, I am blessed to be in the midst of it.

The downpour ends and the women gather up the pads and shields which they have made so far on this day.  Each item is inspected for quality.  The items are put out onto the table, for assembly into Days for Girls washable hygiene kits.  The women show off the washcloths, soap and underwear which they have purchased.  It is actually cheaper to purchase the wash cloths ready-made than to cut and serge them themselves.  They tell me that the pink soap smells the best and causes the fewest allergies.  One of the women searched far and wide and actually found the PUL (water impermeable fabric) and she used a few of her own dollars to buy a piece of it.  She was very excited to make a shield using the fabric she purchased. We break for the homemade breakfast brought in by a few of the women...pupusas, cornbread and hot chocolate.

Each product is checked

Dark flannel is not available in El Salvador, so the women
are asking a local distributor to stock it -- and the pink
soap does really smell good!
A purse for a little
girl made from
rejected product
These women know what they are doing.  They have spent the past 5 months perfecting their sewing skills.  They researched the best prices for fabrics. They outsourced the sewing of the fabric bags to a young mom who sews at home because her baby is due in one week.  They participated in entrepreneurship trainings.  They studied the local market and made a business plan.  They go into schools to teach girls about their periods.  They bring foods to share with one another for breakfast and lunch on work days.  They make small items from scraps and from the shields and pads that are of sub-standard quality and they sell their creations for 25 or 50 cents to earn bus money so they can come to work in the purple house.  They used start-up funds from their sister church to prepare and print a Days for Girls menstruation brochure because they believe each girl needs as much information as they can give her.  They are not earning any pay yet, but they are committed to the project. 

Interior stitching
on cloth bag

By the end of this day, the team of 10 women complete their first 20 kits.  Eventually they will sell the kits at a price which will be fair for the workers and the consumers.

How does a US-based project to teach girls about menstruation and provide kits lead to a group of women entrepreneurs to take steps to form a micro-business?  And how does the project of giving away free kits work alongside a project which will ultimately will employ women in El Salvador in the production, promotion and sale of the kits to women who need them?  To understand how this all works together, let's take a quick look at what has happened thus far and where these projects are going...
  • 2016 - The Mission of Healing team conducts an evaluation of the annual Mission of Healing Family Wellness Fair (put on by the Salvadoran Lutheran Church and the Greater Milwaukee Synod of the Evangelical Lutheran Church in America)  which raises up the need for reproductive system education for girls and women, as well as the need for feminine hygiene products among women without access or means to purchase these supplies.
  • 2016-2017 - the US Mission of Healing team learns about and connects with Days for Girls and begins to sew kits.  Word goes out through the Milwaukee network, the Lutheran Church network, and a story in this blog, and the response to create kits is tremendous!  Women in El Salvador contribute to the construction of Days for Girls kits by sewing drawstring bags which hold the kits.  
  • 2017 Mission of Healing - Salvadoran and US leaders provide a series of charlas (educational discussions) on women's health issues, including:  Breast Health and Self-Exams, Mom and Baby (Pregnancy and After the Birth), Menstruation, Menopause, and HIV/STI prevention.  Days for Girls kits are distributed to girls and young women at the Menstruation Charla.
  • February 2017 - A small Salvadoran and US team visits local health clinics to teach about the Days for Girls kits and share a sample kit at each clinic. Workshops are held at a few Lutheran Churches to talk with girls about menstruation, to teach the girls how to use the kits and to distribute Days for Girls kits to girls who need them.
  • March 2017 - Women in a local church hold a few pilot workshops to study the patterns, to practice tracing and cutting, and to learn how to make the pads.  Patterns and guidebooks are  prepared by a registered US Days for Girls Team to ensure proper procedure and quality control.  Women from the church who have a talent for the work and the passion for women's health education join with women from a local community center to continue the learning workshops. 
    The first workshop - feeling the fabrics, studying the patterns
    and imagining how to help get more kits to more girls
First sewing workshop at the Women's House
  • End of March 2017 - during the course of one month, every woman in the group learns how to trace and cut, to sew the kit components, and to use the snap tool.  Eventually each woman will specialize in the work that she does best.  The first products are not of high enough quality to give away, so the women take them home and use them for themselves or their daughters.  Personal experience strengthens the women's advocacy of use of these kits for economic benefit, environmental benefit and most importantly for their health and confidence.  Over the next several months, the women work together to perfect their sewing skills.  They use a combination of donated fabric and fabric they purchase with a small grant they receive through the church.
  • September 2017 - communication with Days for Girls International hits a setback when the organization communicates that it is unable to handle new solicitations for new Enterprise Groups (micro-businesses) until 2018.  When Days for Girls is ready to approve its first Enterprise in El Salvador, these ladies will be more than ready!
  • September 2017 - the women gather in the pretty purple house on a rainy morning to work and to share their progress with me.  That is where this blog story began (do you need to scroll back up to the top?)  The story continues...
Fabric Fashion Show

Because the women are not earning salaries, I thought it might be fun to do a little raffle with some donated fabric.  These kinds of small acts of kindness and fun really help to keep morale high among the women. (I have written previously about the value of bringing fabric to our sister church.)  I bundled up some large pieces of fabric (not suitable for Days for Girls kits) and tied them up with pretty ribbon.  I brought them with me in a secret bag.

After our delicious pot-luck breakfast, we hold the raffle.  My husband is the master of ceremonies, and of course, everyone wins a bundle, with the first number chosen being the first woman to choose her bundle.  The women are also working on a presentation which they will do for Indigenous Women's Day, preparing a flag and costumes and a traditional dance to honor feminists from Peru.  One of the fabric pieces seems like it might work out as part of a costume before being made into a skirt.  Hilarity ensues when one woman unfurls her bundle to reveal pre-printed Christmas vests - complete with snowmen and snowflakes -- and I never, ever would have predicted that the Christmas vest fabric would be so intriguing and desired by a group of sewing ladies in El Salvador!

Just a week after my September visit to the purple house, the co-leader of this new church-community-women's sustainability project contacts me to see if I can whip up a presentation for an event we had planned for 2 days later.  What was planned as a visit of a couple of my friends from the Milwaukee Synod was now expanded to a big celebration of the women and their work.  When my friends and I show up, we are impressed!  Local school officials and principals, government workers, political party representatives, and leaders from a variety of social agencies (from environmental groups to women's rights groups) all listen intently and ask a lot of questions.  At the end of the presentation, we highlight the plan that has been developed for two pathways as we go forward:

1)  Women in the United States are continuing to sew Days for Girls kits in preparation for the 2018 Mission of Healing Family Wellness Fair.  The US sewing teams are partnering with Salvadoran women as in 2017, with the Salvadoran women making a significant quantity of the drawstring bags.  The US Days for Girls registered team is supplying the Salvadoran women with the logos to put onto the bags.  Donated kits will be given out during the Mission of Healing Family Wellness Fair 2018 as part of the Menstruation Charla.  Donated kits will be given to girls who need them in follow-up workshops after the Mission of Healing, for as long as the kits are available.  Donated kits will continue to be needed to provide girls and young women who live in poverty or remote areas with the ecological and economical feminine hygiene product they need in order to be able to study and work.

2)  Women in the small purple house are working toward registering their micro-enterprise.  They are working with the appropriate women's entrepreneurship agencies of the Salvadoran government to register the Days for Girls design as the intellectual property of Days for Girls so that no one in El Salvador steals the design and begins to mass-produce the kits to sell for profit without legal permission to do so.  The goal of producing Days for Girls kits in El Salvador by Salvadoran women as a sustainable micro-business will provide a local source for the girls in El Salvador to purchase their kits.  The micro-business does already have a legal name and potential clients lined up as schools and health clinics want to be able to purchase kits to GIVE to girls who need them.

1.  Support Days for Girls International.
2.  Sew Days for Girls Kits and connect with the Greater Milwaukee Synod of the ELCA to send your kits to El Salvador as part of the February 2018 Mission of Healing.
3.  ALWAYS INCLUDE THE OFFICIAL LOGO purchased from Days for Girls on any kits you create and send out into the world.  If you send kits to the Greater Milwaukee Synod without logos, please consider sending a small donation so that the affiliated Days for Girls Teams can purchase the logos and sew them onto the bags.

Tuesday, October 10, 2017

An Afternoon for Tales

Sonia told me that her friend really wanted me to come to her house.  I was not exactly sure who the friend was, though Sonia insisted I had met her a couple of times. The friend wished to express her gratitude for the positive impact I had had on her family and the women in her community.  I was   genuinely touched by the invitation delivered through a friend.  We arranged a date, and on a sunny Sunday afternoon, four of us drove out to the farm.

The farm is nestled in the hills, down a cobbled and mud path, well-hidden below the main road.  We stepped out of the car and breathed in the warm scent of earth and wet leaves.  Three little sheep blurted out their welcomes.  Beyond the sheep, the pastures opened up into two emerald bowls, framed by trees and wire fences atop earthen rims.  We followed our hostess down a little path toward her house - one of a few homes in close proximity.  This farm is actually a small community made up of members of one big, extended family.  A deep moo emerged from the pasture.  This was the El Salvador of painters' imaginations and of romantic folk dances.  This was the beloved El Salvador, preserved in the tales of campesinos and campesinas de la tercera edad.

The home was low and sprawling, with 50-year old wooden beams and adobe walls.  Rooms had been added over time - a baking kitchen with a round earthen stove, a kitchen with the comal and open fire,  the wash area with running water and a long, rectangular pila, bedrooms, storerooms, and two indoor bathrooms.  A wooden wheel stood in a corner, home-made tools for baking and for working the land stood or hung in their places.  It felt like a living museum.

Our hostess scurried around to finish making lunch between bits of conversation. The warmth, the kindness, and the welcome given to the four of us was biblical.  The daughter, our hostess, lives with her elderly parents.  Her mother is very ill, and the women spent considerable time at her bedside while the men listened to stories.

The chicken soup with vegetables was delicious.  There was a little conversation about the kindest way to kill a chicken.  A plate with round mold of soft cheese (a gift from the mooing cow) came out of the fridge.  Would we like toasted tortillas for the cheese?  Oh, yes please.

The daughter learned all of her skills from her parents.  The farm is self-sufficient.  The father built the home and all of the buildings on the farm.  He plants and tends and harvests with the knowledge gained over years.  The father told us he never went to school, he cannot read or write, but he can raise animals.  And he can tell stories.  Oh my, can he tell stories!

Each story began exactly the same way:  "I will tell you a pasada; it is from the Antiguo Testemento." We soon recognized that a pasada is a tale from the past - like a fable, and if it is from the Antiguo Testemento (the Old Testament) it is a fable which has been told by generations of story-tellers.  I think we must have listened to 25 or 30 pasadas during our visit.

As I listened to the father's tales, I promised myself I would try to remember them - or at least one of them.  Some day I will need to return to the farm with someone who can interpret the stories a little better than I can because they are filled with local references and caliche (slang) that make them tricky to follow.  One story did stick with me.*  Picture an old man, standing in the field, cows frolicking on the hillside, dogs barking and roosters crowing.  The old man begins...

I will tell you a tale from the past.  It is from the Old Testament.  It is about St. Joseph, his wife Mary and the boy Jesus.  Of course Jesus has all knowledge, and he spoke perfect castellano (Spanish).  He was just about 3 years old.  Joseph was working every day in the milpa (corn field), and it was Jesus' responsibility to take lunch out to his father in the field.  Mary made lunch from what she had in the house:  a couple of small tortillas and some beans.  Jesus thought, "Oh I wish we had something besides small tortillas and beans.  I would really like to take Joseph some cheese."  

It was still morning, so Jesus laid down and took a little nap.  He was only three years old.  When he woke up, there on the table were a stack of tortillas as big as dinner plates and a large cuajada (mound of soft, wet cheese).  Jesus realized this was not a dream, but the large tortillas and fresh cuajada were real!  

Mary told Jesus it was time to take lunch to Joseph.  Jesus divided the cheese into two parts.  He took half the tortillas and half of the cheese and walked out to the field.  When Joseph saw the tortillas and cheese he was surprised.  "We did not have any cheese in the house," he said, "only small tortillas and beans.  Where did these come from?"

Jesus answered, "From my Father."  

And Joseph was a little confused.

*I am sure that I did not remember all of the details of this story.  Some day, I hope I can return to the farm with a notebook and a recording device.  The tales told on this wonderful afternoon are worth remembering and sharing.  If you have heard this story before, please share your version in the comment section!

Thursday, September 28, 2017

Medical Brigades

Medical's a complicated and messy topic whether you are in El Salvador or the United States or probably just about any place in the world.  The disparity between what is available between one country and the next seems unfair.  The disparity between what is available to people with resources or insurance and people without resources or insurance seems unfair.  The sense of unfairness and awareness of disparities along with genuine desires to do good in the world drive people from the United States to organize mission groups to care for people in El Salvador.

The topic of this story:  Medical Brigades.

If you are a regular reader of my random stories, you know that healthcare in El Salvador is a topic about which I frequently write.  Search "medical" or any other healthcare type words, and dozens of stories will pop up.  I am not a professional in a medical field, but I have a 17-year history of walking with the Salvadoran people in the areas of health and education.

Why this topic at this moment?  In one word:  stories.

This is the time of year during which the folks in my synod of the Lutheran Church (ELCA) in the US are working with their Companion Synod, the Salvadoran Lutheran Church, to define the plans for the annual Missions of Healing Family Wellness Fairs which take place each February.  As I am engaged in conversations in El Salvador with the on-the-ground planning team, I keep hearing stories.  A common theme:  Medical Brigades.

I am going to state right here that I do believe Medical Brigades have their place.  What we currently plan with our companions has evolved over the years and it was rooted in what might be described as a Medical Brigade (although we have never used that terminology).  When Salvadoran Lutheran Church folk or US Lutheran folk refer to what we do together as a Medical Brigade, someone is always ready with the correction:  Mission of Healing.  Still, the term Medical Brigade is used all the time and medical brigades are working all over the country.

In the early years, the communities we connect with did not have access to medical care.  There was no medicine available.  There was one pharmaceutical laboratory in El Salvador with a monopoly on the market and only a few products.  Generic medicines from the US were not available locally.  We started our work in communication with the clinic nearest to our focus community and brought what the doctor there recommended.  We assembled a team of medical professionals to help diagnose illnesses and care for the people.

The situation now in El Salvador is that there are multiple pharmaceutical laboratories and competitive prices.  Front-line US medications are not available in El Salvador, but older forms and generics are.  People do struggle to pay for medications if their free clinic or insurance-based clinic does not have the correct medications in stock.  In the cities, there are multiple pharmacies on every corner.  The supermarkets in the city and small towns carry everything from anti-parasite medication to pain-reliever to cough medicine. And in just about every town, there is a story about a recent Medical Brigade.

Here is an example of how this played out yesterday when a few of us were hanging out before a meeting...
Pastor #1:  I am so thankful for the Mission of Healing that we did 2 years ago at the park in our community.  The director of the clinic continues to thank me for the excellent education which you gave the people.  She is building on that and is giving out less than half of the medicine she did before.  The people are healthier because they are not taking this pill and this pill for every small thing.  They are using the natural recipes and managing chronic illnesses with better control of their medications.  She is so happy to get started on the plans for the coming year.
Pastor #2:  The fair we did at the school last year was so beautiful.  The people learned so much as families.  The teachers at the school still talk about it. Did you know after that we had a medical brigade?

There it is:  Medical Brigade.
Pastor #2 continues:  I think it was in March or April.  No, I don't know where they were from, somewhere in the US.  It was very stressful for me.  The people were lined up at the school, and they were standing there for more than 2 hours.  They kept saying, "Pastor, when are they coming?" I was worried they would not show up.  Then they did.  They were more than 2 hours late because they had to buy all the medicine at Walmart.  Some of the people had to leave so they just got their medicine.  In the end it was OK, but I was so worried.

I have questions.  Why would someone schedule a Medical Brigade to come to a town where a Mission of Healing had happened 2 months prior?  Why would a Medical Brigade come to a town which has a clinic and a mobile medical unit (ECO)?  Were the people so unhappy that we did not dish out medicine like candy at the Mission of Healing that they clamored for a Medical Brigade?  (We do give every family a basic kit with some basic medications for the home.)  I am pretty sure there are places out in the far and wide in El Salvador or even in the central city that could really benefit from a Medical Brigade.

Also yesterday, as a little group of us sat in my church office...
Evangelist:  The Unidad de Salud (local health clinic) is doing Medical Brigades next month in the schools.  They are bringing doctors and nurses and medicines and all the students will have check-ups.  When you come next year for the Mission of Healing, we will work with them.  Is it OK if they bring more medicines and a bigger team than last time?  If they provide exams, such as PAP tests, for sure we will want medicine on hand for sexually transmitted illnesses.
Yes, I say.  This is exactly the kind of collaboration we are growing:  the local clinic bringing its local health professionals, working side by side with us and using the medications which are appropriate and locally available.

The Evangelist continues:  So at the "Medical Advice" table people can bring their medicines and ask questions about how to use them, right?  Sometimes at the Unidad they do not give good instructions because there isn't time.  You can help with that, right?  And if the Unidad does not have the medicines they need for the exams they are doing, do you think you can collaborate with the government to help purchase some?
I make no promises, but this sounds like a reasonable idea to me.

In this community, the local goal is to have a Mission of Healing Wellness Fair annually.  We help every other year.

I learned this morning that one week after next year's Mission of Healing, a team of US professionals working with a non-governmental organization will have a Medical Brigade in the same location where the school brigades and the Lutheran-based Mission of Healing are taking place.  I know no details, but I wonder why we cannot do a better job of communicating with one another, in El Salvador and outside of El Salvador, so that we are not saturating certain areas with gobs of resources while other areas never receive a bit of help.  Disparity.  In a society which is crazy about medications (and I recognize the US is not a model example on this point), and a society in which medical professionals and teachers are working to change the "pop a pill for everything" mindset, the Medical Brigade culture in El Salvador, in my opinion, is not always helpful.  It could be argued that is some forms, it is harmful.

Yesterday, my husband stopped by a home to pick up what he thought were photographs to take to a family in the US.  When he arrived, he was presented with a variety of items including a group of syringes containing red liquid.  The idea was for us to take these back to the US because it is a good medicine for fever and the family member in the US needs it.  We think the red liquid was actually vitamins, but there was no clear packaging.  This kind of confusion with medicine happens ALL the time in El Salvador.  It is bad enough with their local products given in their local clinics, but even worse, in my experience, when people receive medications from the US during a Medical Brigade.  So often, bags are not labeled, patients cannot read the labels, patients cannot read at all, the pills are different colors than those used in El Salvador so patients mix them up, and once the medication is gone, people have no idea how to explain the medication's use to their local clinic personnel.

Over the years we have surely made some bad decisions with the Mission of Healing, but we hold tight to two core values:  accompaniment and adaptation.  I don't think the Medical Brigade culture in El Salvador will change very soon.  My hope is that the healthcare system, churches and charitable organizations can better coordinate so the the people of El Salvador who need care can get it and so that those who come to El Salvador to do good, do not do harm