Delegation Selection
-Helpful to have some Spanish for every member
Pretrip Contact of Resource Person
-Helpful for support
Preparation/Needs Assessment Prior to Trip, Contact list
-Fondo physician
-Tierra Blanca Unidad director
-Jiquilisco hospital lead physicians
-HIV Clinic in San Salvador
-CIS
-Dean Brackley
Pretrip briefing session
-Need to be clear with goals of medical visits
-Ideally team is made aware of local projects in process (renal failure study)
Itinerary
-Ideally R&R day on Wednesday
-After lunch sitting limited to 30-45 minutes
-Best combination is sitting then walking
-Continue morning and evening reflections
-Need to have more sharing of medical visit experiences
-Keep Romero home/chapel visit
-Keep Dean Brackley visit
-Iterinary should include meeting with Fondo doctor and Tierra Blanca Unidad
Computer Access
-Need better access in the evening, & morning
-We can supply a wi-fi router for less than $100, have constant access
Medical Visits
-Need a formulary for teams
-Ideally backpacks could be pre-packed with formulary meds
---Tylenol
---Multivitamins with iron
---TUMS and H2 blockers (Pepcid, Zantac)
---Hydrocortisone cream
---Antifungal cream
---Antibiotics – oral, topical
- Standardize history and demographics
---Preprinted H&P forms?
---Possible to get demographics from animador?
-Improve process for arranging follow-up
---Currently up to Sisters Fran/Elena
---Ideally could impart some responsibility to animator
Future Considerations
-What should be the depth of involvement?
---Periodic/Annual social/medical home visits (current level of involvement)
---Periodic/Annual health advisors to community leaders
---Partnership with local physicians
---Community public health needs assessment
---Permament or intermittent Providence clinic
---Providence hospital
-Who is the focus of future efforts? Delegations or Communities?
-What should be the scope of effort?
-Worldwide scope vs focused regional projects
-What process should be used to move forward?
Discussion Points of the Group
-International mission needs to be linked with U.S. mission
-International efforts need to be supporting local community, NOT directing community
-Plan must be sustainable, impactful, partnered with grassroots efforts
-Should include health and business development
-This requires more of a presence
-Local relationships already developed by Sister Fran who has created a legacy
-Entering new communities would take years
-Latin America geographically convenient relative to other parts of globe
-Internal Providence process for development of a strategic plan
-Intentional focus on personal formation relative to immersion
Sunday, November 22, 2009
What happens next - Saturday
In the gospel reading for Saturday, the Sadducees proposed to Jesus the dilemma of what happens in the afterlife when a woman has had seven husbands due to their sequential death. The purpose of the question appears to have been to catch Jesus in a logical conundrum of the future. Jesus' response suggests that the Sadducees would be better off focusing on the concerns of today. For all of us, Saturday was a day reflecting on the previous week, and the future of what will come in El Salvador.
We began the day with a visit to Centro de Intercambio y Solidaridad (CIS) (see link top right). CIS has a variety of programs, ranging from forming and guiding small business cooperatives to running a Spanish language school with the mission of promoting solidarity and cultural exchange between Salvadorans and their american neighbors. We met Friday night with Leslie Shuld, the director of CIS, who shared insights and experiences from working in El Salvador with CIS for 16 years. She shared with us that although coffee replaced indigo as the primary export of El Salvador in the 1870's. indigo is making a comeback as a natural dye to the point where local cooperatives have a hard time buying it affordably. In our visit to the CIS office in San Salvador, our goal was to find presents for friends and simultaneously support grassroots cooperatives with fair prices.
After this stop, we visited a more typical artesan (read tourist) market where goods were many and Maestro Mateo demonstrated his haggling acumen. Across the parking lot was our lunch stop, yes, a pupuseria. After this we visited the Contrasida (Against AIDS) Foundation, and met with one of their health educators who gave us a sense of HIV/AIDS in El Salvador. This was dramatically illustrated with a story of Juan and Miguelito and... well, let's just leave it at that.
To close the week, we made a pilgrimage of sites associated with Oscar Romero, the Salvadoran archbishop, who was murdered on March 24th, 1980 after being archbishop for only 3 years. If you enter any Salvadoran church, you are more than likely to see an iconic image of the man who was transformed from a shy and bookish scholar to the chief voice and inspiration of the poor in El Salvador during the government repression of the late 1970's. A 1993 report by the United Nations identified Roberto D'Aubuisson, founder of the ARENA party, in ordering the death of Romero by a death squad. The murder was the spark which ignited the 13 year long war between the government, let by the ARENA party and the FMLN. 1993 marked the end of the war, but ARENA has remained the dominant party for the last 16 years.
We visited the home of Archbishop Romero, a very small one bedroom house, near a small chapel called "Divine Providence". We saw the garments he wore while celebrating mass. One can clearly see the hole made by the single bullet which struck his heart while holding up the eucharist. We had a chance to meditate in the chapel and consider the deeper meaning of his assassination in the conscience of El Salvador. Lastly, we drove to the Cathedral of San Salvador which houses his remains in a crypt below the church. In 1997, John Paul II declared Romero "blessed" (first of three steps to become a saint).
At the end of the day we sat down for a debriefing session of the week, discussing what worked, what could be changed, and future possibilities for Providence in El Salvador.
We began the day with a visit to Centro de Intercambio y Solidaridad (CIS) (see link top right). CIS has a variety of programs, ranging from forming and guiding small business cooperatives to running a Spanish language school with the mission of promoting solidarity and cultural exchange between Salvadorans and their american neighbors. We met Friday night with Leslie Shuld, the director of CIS, who shared insights and experiences from working in El Salvador with CIS for 16 years. She shared with us that although coffee replaced indigo as the primary export of El Salvador in the 1870's. indigo is making a comeback as a natural dye to the point where local cooperatives have a hard time buying it affordably. In our visit to the CIS office in San Salvador, our goal was to find presents for friends and simultaneously support grassroots cooperatives with fair prices.
After this stop, we visited a more typical artesan (read tourist) market where goods were many and Maestro Mateo demonstrated his haggling acumen. Across the parking lot was our lunch stop, yes, a pupuseria. After this we visited the Contrasida (Against AIDS) Foundation, and met with one of their health educators who gave us a sense of HIV/AIDS in El Salvador. This was dramatically illustrated with a story of Juan and Miguelito and... well, let's just leave it at that.
To close the week, we made a pilgrimage of sites associated with Oscar Romero, the Salvadoran archbishop, who was murdered on March 24th, 1980 after being archbishop for only 3 years. If you enter any Salvadoran church, you are more than likely to see an iconic image of the man who was transformed from a shy and bookish scholar to the chief voice and inspiration of the poor in El Salvador during the government repression of the late 1970's. A 1993 report by the United Nations identified Roberto D'Aubuisson, founder of the ARENA party, in ordering the death of Romero by a death squad. The murder was the spark which ignited the 13 year long war between the government, let by the ARENA party and the FMLN. 1993 marked the end of the war, but ARENA has remained the dominant party for the last 16 years.
We visited the home of Archbishop Romero, a very small one bedroom house, near a small chapel called "Divine Providence". We saw the garments he wore while celebrating mass. One can clearly see the hole made by the single bullet which struck his heart while holding up the eucharist. We had a chance to meditate in the chapel and consider the deeper meaning of his assassination in the conscience of El Salvador. Lastly, we drove to the Cathedral of San Salvador which houses his remains in a crypt below the church. In 1997, John Paul II declared Romero "blessed" (first of three steps to become a saint).
At the end of the day we sat down for a debriefing session of the week, discussing what worked, what could be changed, and future possibilities for Providence in El Salvador.
Changing the System - Friday
We awoke on Friday knowing it was our last day in Bajo Lempa. The gospel reading of the day told of Jesus turning over tables in the temple because of all the unjust business practices going on there; "You have made it a den of thieves". Mino made a direct connection between the corrupt dealers in the temple and the immoral political and business leaders in El Salvador, and shared the desire to follow in Jesus' footseps, driving them out.
On our last day, we visited the community of Papalote, a small village to the west of Tierra Blanca. Again, we divided into three teams to visit various homes. We visited a home of an elderly woman, who lived alone with her husband, but her house was full of 7 children, 3 grandchildren and 4 children of a helper. The school year runs from January to November, so the kids were out of school, as they have been throughout the trip.
After this we returned to Centro Romero to pack, and say goodbye to Morena (cook at the center) and Sister Elena. We donated the remainder of our medicines to Adrian, the physician who works at the Fondo de Emergencia. He shared with us, that as a physician for the Fondo, he earns less than his wife who works as a nurse in San Salvador, where he returns each weekend to be with his family. He expressed the hope of becoming the next director of the Unidad (Government run health clinic) in Tierra Blanca.
We boarded the bus with Hernàn for San Salvador, stopping at a highway Pupuseria along the way. For anyone who has never eaten eaten them, pupusas are uniquely Salvadoran. They are made by frying up a thick tortilla filled with cheese, meat, beans, or vegetables. Generally they cost 40-60 cents.
We arrived in San Salvador where we had been one week before at the Universidad de Centroamerica (UCA), and had an hourlong session with Dean Brackley, S.J. who is a professor of theology there. He is truly a font of knowledge about Central America and shared with us a fraction of this, which I have summarized here:
Demographics:
Median age of El Salvador, 23
Minimum wage: $170/month
Average wage: $250/month
Poverty rate: 65-80% (depending on definitions)
Typical education: 6yrs
Percent unable to get enough calories: 40%
Economy in crisis:
Father Brackley described the "baseline" economy as being similar to the U.S. during the great depression. In the last 2 years, the economy has had 2 major crises: the gas crunch of 2007-8, and the collapse of U.S. banking system in 2008-9. This has hurt El Salvador in 2 ways: decrease in remittances (money sent from Salvadorans in the U.S.) from $3.8B (which is 18% of GNP). as well as direct effect on economy due to decreased exports, access to credit.
Taxes & Trade:
All food and retail products are subject to a 13% value added tax. This of course hits the poor disproportionately, while many rich are able to evade this tax. There is no income tax. In recent months, the newly elected President, Mauricio Funes of the FMLN party, has attempted to make small changes in closing tax loopholes, to the whining and howling of the wealthy. For Salvadorans, CAFTA (Central American Free Trade Agreement) is considered neither "free", nor "fair".
Signs of Hope:
In June of 2009, Salvadorans elected a president from the FMLN for the first time in history, Mauricio Funes. In addition, 13 legislators previously aligned with the ARENA party have broken away, opening the possibility to pass legislation to correct some systemic injustice. There is a new attorney general who has promised to investigate killings which still occur occasionally. For example, there have been recent killings, appaently motivated by opposition to mining companies eager to come in to El Salvador and extract gold with cyanide. There are 4 new supreme court justices appointed by the new president. The greatest source of hope is the youth of the country, growing up in the post-war years.
All of us were enriched to have spent the hour with him, and wished for more. Needless to say, we were all left with the anger Jesus felt in seeing the injustice of the system.
After our visit we headed back to our hotelito, where some crashed after dinner, and some had the energy to go out with Erica, aka "la loca bailando".
On our last day, we visited the community of Papalote, a small village to the west of Tierra Blanca. Again, we divided into three teams to visit various homes. We visited a home of an elderly woman, who lived alone with her husband, but her house was full of 7 children, 3 grandchildren and 4 children of a helper. The school year runs from January to November, so the kids were out of school, as they have been throughout the trip.
After this we returned to Centro Romero to pack, and say goodbye to Morena (cook at the center) and Sister Elena. We donated the remainder of our medicines to Adrian, the physician who works at the Fondo de Emergencia. He shared with us, that as a physician for the Fondo, he earns less than his wife who works as a nurse in San Salvador, where he returns each weekend to be with his family. He expressed the hope of becoming the next director of the Unidad (Government run health clinic) in Tierra Blanca.
We boarded the bus with Hernàn for San Salvador, stopping at a highway Pupuseria along the way. For anyone who has never eaten eaten them, pupusas are uniquely Salvadoran. They are made by frying up a thick tortilla filled with cheese, meat, beans, or vegetables. Generally they cost 40-60 cents.
We arrived in San Salvador where we had been one week before at the Universidad de Centroamerica (UCA), and had an hourlong session with Dean Brackley, S.J. who is a professor of theology there. He is truly a font of knowledge about Central America and shared with us a fraction of this, which I have summarized here:
Demographics:
Median age of El Salvador, 23
Minimum wage: $170/month
Average wage: $250/month
Poverty rate: 65-80% (depending on definitions)
Typical education: 6yrs
Percent unable to get enough calories: 40%
Economy in crisis:
Father Brackley described the "baseline" economy as being similar to the U.S. during the great depression. In the last 2 years, the economy has had 2 major crises: the gas crunch of 2007-8, and the collapse of U.S. banking system in 2008-9. This has hurt El Salvador in 2 ways: decrease in remittances (money sent from Salvadorans in the U.S.) from $3.8B (which is 18% of GNP). as well as direct effect on economy due to decreased exports, access to credit.
Taxes & Trade:
All food and retail products are subject to a 13% value added tax. This of course hits the poor disproportionately, while many rich are able to evade this tax. There is no income tax. In recent months, the newly elected President, Mauricio Funes of the FMLN party, has attempted to make small changes in closing tax loopholes, to the whining and howling of the wealthy. For Salvadorans, CAFTA (Central American Free Trade Agreement) is considered neither "free", nor "fair".
Signs of Hope:
In June of 2009, Salvadorans elected a president from the FMLN for the first time in history, Mauricio Funes. In addition, 13 legislators previously aligned with the ARENA party have broken away, opening the possibility to pass legislation to correct some systemic injustice. There is a new attorney general who has promised to investigate killings which still occur occasionally. For example, there have been recent killings, appaently motivated by opposition to mining companies eager to come in to El Salvador and extract gold with cyanide. There are 4 new supreme court justices appointed by the new president. The greatest source of hope is the youth of the country, growing up in the post-war years.
All of us were enriched to have spent the hour with him, and wished for more. Needless to say, we were all left with the anger Jesus felt in seeing the injustice of the system.
After our visit we headed back to our hotelito, where some crashed after dinner, and some had the energy to go out with Erica, aka "la loca bailando".
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