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Karen Cowgill, RN, MPH, September 1993
The zone where MDM works is mountainous and beautiful (at least during the rainy season when everything is green). Towns and villages are connected by rocky dirt roads or by narrow paths. The main source of livelihood is sowing corn and beans. Some families generate income to supplement these staples and to buy goods by making hammocks or shoulder bags out of string spun from the maguey plant (agave) or with sugar cane or produce. The best houses are made of adobe with tile roofs; virtually all have dirt floors. Some houses are made only of bamboo, with perhaps a sheet of plastic or tin covering a wall on one side. Very few families have latrines; most draw their drinking water from contaminated communal cisterns where they also bathe. Pigs, dogs, cats, and poultry run around the yards and houses pretty much as they please. The kitchen hearth is usually inside the house, and smoke slowly migrates horizontally out doors or windows. There is no electricity and people generally go to bed soon after sunset and get up around sunrise, sleeping in hammocks or on narrow wooden beds. The chickens stay inside at night to protect them from coyotes.
Such unsanitary living conditions are the cause of many health problems. I went to one of the health promoters' presentations to the community of Babilonia, in which they explained the need for latrines and the serious problems (such as cholera) that not having them can cause. Maruca had come along to observe and she picked up when the promoters hesitated. A middle-aged man who stood in the corner at the back and seemed to be a leader in the community said it was all well and good for MDM to tell them they need latrines, but who was going to give them? The promoters suggested people dig holes and use simple materials like stones and boards since no funds for concrete and little houses (to build over the latrines) were forthcoming. Then it turned out that some people already had latrines...How many? Maruca wanted to know. How many of those here today have a latrine? And do you use it? How? Do you throw the papers inside or out? Do you sprinkle lime or ashes in it? How often? Then it turned out there was some materials for latrines waiting to be constructed... How long? Three years! Why haven't they been built? And those of you who don't have materials, can't you dig a hole?... Some of us are single mothers, we don't have anyone to dig the hole... How many men does it take to dig a hole?... Two. How long?... Three hours. And so on. It was a classic example of community organizing. She got many people in the audience talking, thinking about ways to improve the situation, and the meeting ended with the chair of the Health Committee scheduling a community meeting to address the issue.
Since the El Salvador Mission began, it has helped build over 1,000 latrines in the three municipalities it serves.
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