On Friday, after a couple of days out in the countryside dodging cows and learning about rural, door-to-door medicine, we traveled back to where it all began: the little clinic in Distrito Italia. We were pretty excited to go there - to see if maybe some of the original staff was still there, to see how the clinic has changed since our last visit there several years ago, and to connect with the medical staff who regularly interact with folks from our sister church community.
The director of the Unidad de Salud (health clinic) was eager to meet with us, but was busy conducting an autopsy when we arrived, so we waited for a bit. Curiously, a motorcycle was parked next to a set of stairs-to-nowhere in the middle of this strange little waiting area. Modern art? Physical therapy zone? We couldn't decide. Pretty soon the autopsy was complete and the director led us into a very nice, large, air-conditioned conference room. We talked about the retirements of some of our friends, and others who were working in different clinics. We were super happy to see the head nurse, an old friend. We made good plans for working together.
Despite the fancy meeting room, it was pretty clear that this Unidad has some pretty big challenges. They have no phone lines (apparently local thieves made off with the cable - more than once) so the doctor and head nurse give out their own cell numbers to manage emergencies. Most communication, setting up appointments, etc. must be done in person. As local gang boundaries shift from one community to another, the staff is flexible with accepting patients who technically should be visiting another nearby clinic for their care. Because this area has been designated as "urban" there is no ECO or team of health promoters to travel to the homes to provide care. This is a very big challenge, because although the communities surrounding Distrito are only a bus ride away from the city of Apopa, the families live on tiny plots and survive by living in large family groups and pooling together resources from farming rented land, working as day laborers, raising a few chickens and selling items in the market. Poor sanitary conditions, low water quality and insufficient control of mosquito habitat greatly impact the quality of health in these poor communities.
We toured the facility. The pharmacy was small, but seemed to have the basics. The exam rooms were clean and most had been remodeled. We were surprised to find a large physical therapy room with a few pieces of old yet functional equipment. We were very surprised to meet the psychologist and two members of the art therapy team. In a region where poverty and violence touch every family, this art therapy team is a true blessing! We were absolutely impressed with the enthusiasm and creativity of this team, and with their availability to go out and do workshops in different communities. We know from our years of work with the Mission of Healing that this type of healing resource in a community can do much more to heal the spirits of the people than a little zipper bag of ibuprofen.
We spent quite a long time talking with the director and all of the staff members and imagining ways in which we could work together in the future. As the church works to develop its team of health promoters, there will surely be opportunities for the church and the Unidad to complement one another.
|Gasoline for the mosquito fumigation machines|
|Fumigating for mosquitoes|
|Clinic director in the dental treatment area|