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DGH and I both have our roots in El Salvador, in witness, and in accompaniment. Looking in the rearview mirror of my own life, I believe that we grow and get far more from these experiences than we give. They change us forever in ways that continue to unfold throughout our lives.

This year I returned to El Salvador for the first time since just after the Peace Accords. On that trip in 1992 I had hoped to visit Lanny in Morazán, but the military did not forgive or forget that easily. Though their Ambassador at the U.N. had personally issued my visa, the military pulled me into an interrogation room and read my yard-long 'rap-sheet.' They reminded me that the Ambassador lived comfortably in NYC and had not fought in the war. I was able to meet with some of the demobilized guerrillas from Guazapa. Unable to clearly read the signals of security forces that continued to watch and harass me, I cut the trip short.

“Looking in the mirror of my own life, I believe that we grow and get far more from these experiences than we give. They change us forever in ways that continue to unfold throughout our lives.”

I returned this year for the 25th memorial of Archbishop Oscar Romero's assassination. It was a very powerful occasion: the Memorial of Cuscatlan, which is the wall of names of civilian dead reminiscent of the Vietnam Veterans Memorial; meeting with many people I had not seen since the war, whom I was not sure had survived; meeting a college student whom I was told by his father I delivered under difficult circumstances under the noses of a military garrison atop the volcano; seeing a thriving cooperative of ex-combatants that includes men who fought on both sides of the war; seeing how very little has materially changed for the lives of peasants and urban poor.

I saw person after person who had a story that I hardly recognized about how I had saved them or their child or family member. It began to dawn on me that what had been important and perhaps lasting about my moment in their lives was that I brought them hope where hope was hard to find.

Dr. Charlie Clements giving a keynote address at the DGH Tenth Anniversary General Assembly on August 6, 2005, at Columbia University in New York City.

Those encounters with them were usually brief. I walked a circuit of some dozen villages in a 225-square mile area, seeing patients from 7am to about noon. Then I would visit those who could not make it to the clinic, eating a couple of tortillas and a few beans for lunch. After that I would walk to the next village, which might be four or six hours away, depending on whether it was the rainy season and whether I could hide amidst the lush ground cover. In those morning clinics, I would see fifty to sixty patients, so there could not have been more than a few minutes with each patient.

I would give them a little medicine, sometimes a placebo of vitamins and as much kindness and gentleness as possible. As I look back at their memories of those encounters, I think more than anything I offered them dignity, of which there was not a lot of in their lives. I think the gift of dignity is what also gave them hope. They remember those encounters in grossly exaggerated ways that would lead you to believe I was a Bernard Cooley instead of a young physician who had only completed the first year of a Family Practice residency.

I know what I say will have a resonance with your own experiences. And I think we can generalize even further. I think the act of accompaniment, the act of standing beside people in stress, whether the stress is violence, injustice or poverty, "brings hope to people in whose lives hope is hard to find."

And, of course, as physicians we bring hope as well, even when hope is hard to find. I applaud all the partners who have traveled from afar, and all of you, who have struggled to continue to provide not only the avenues for service and witness, but the opportunity for personal transformation that comes with the kind of work you do, and the hope you have brought to so many.

I think that what you have done and what you are doing there and elsewhere is incredibly important on many levels. One that we should not discount is the power of witness. Quakers call it 'speaking truth to power.' There is incredible power in the stories we can tell as health care providers, because the language of health is universal transcending borders, cultures, languages and politics of all varieties.

“Whatever else we choose to do in life, we must attend to and take seriously our responsibilities as citizens in the global super power, because in reality we are voting for the disenfranchised of the world.”

I was on an emergency human rights mission to Iraq just prior to the outbreak of the current war. We were taken to a small pediatric hospital. We had translators with us from Jordan because we wanted to have our own translation, and they were used to translating everything both ways immediately. The pediatrician in the small hospital with 50 beds said the census was now 156. Of course there were mothers with each of the children at the hospital and two slept on the floor and they rotated the beds so each of the mothers and her child got the bed every eight hours.

The pediatrician led us to a mother who was holding her daughter of about three or four in her lap quite emaciated, mewing like a kitten. He explained that the mother had traveled eight hours because she had heard this hospital had the medicine to treat Kala Azar (leishmaniasis). The disease had been well controlled before the first war but, when the import of pesticides were prevented by the US embargo, the sand fly that transmits it began to cause an epidemic.

Then the doctor said in perfect English, "I haven't told the mother yet there's no medicine. It would be kinder if we shot this little girl in the head rather than send her home to die the lingering death that awaits her." He had said it in English so the mother would not understand but the translators, used to translating everything immediately, translated it to Arabic. And the mother's eyes overflowed with tears.

I believe pediatricians are the kindest physicians in the world and it was the sting of what that pediatrician had said that said the most about pre-war Iraq.

I went back to an Internet Café in Baghdad that night and sent that story to about twenty friends whose e-mail address I could remember. You could not surf the Internet but you could send and receive e-mail from an address that was undoubtedly monitored. I encouraged my friends to share the letter with their colleagues. Within hours that story was ricocheting around the world. Within ten days I was getting responses from activists in the West Bank, Argentina, China, India, Austria, Kenya and Vietnam.

Our stories, our witness, the plight and lives of our patients have a poignancy that is at times transcendent. I hope you encourage participants in DGH opportunities to keep diaries. Had it not been for my diary in El Salvador, I don't think I could have written my book, Witness to War.

As we move from one stressful situation to another, one improvisation after another, one heartbreak to one triumph, it is easy for the details to fall by the wayside. Though I wrote Witness to War only six months after leaving Guazapa, I would read a page of my diary and twenty pages of memory would come flooding back, but without the diary those details might not have been accessible. I think a diary is also invaluable in documenting our own subtle transformations that we might not otherwise recognize, or worse yet, want to acknowledge.

Another level of impact of accompaniment on me has been how I come to understand the US, its culture, and its impact on the world by living in another culture. Most Americans never have that privilege and so they are puzzled by how we are regarded in the world today. They are perplexed about the origins of terrorism. They are too often deluded by our own propaganda, which I think is one of the greatest dangers in the world today.

If the President can lie about weapons of mass destruction, if he can fool the world that Saddam's toothless army was a threat to his neighbors, if he can convince the public that there was a direct link between Saddam Hussein and Al Qaida where there was none, if he can rationalize a war whose ultimate victims are largely civilian because we need to 'liberate' them in the name of democracy, we are seriously endangered as a culture and as the world's sole superpower.

In the US, we spend half of the world's total military expenditure, more than $500 billion annually, and we still are not secure. We seek inexpensive sources of oil, and we pay the price in blood, a little of our own but mostly that of others. Iraq costs us $4 billion a month but those are only the monies we are allowed to know about. We know the real costs of wars only come out when the 'black budgets' are revealed years later.

And so how do I tie this all together—your anniversary, the transformative work, and witness of DGH; the hegemony, arrogance, and abuse of the United States in the world today; the tragedy of Hiroshima and the trashing of the non—proliferation treaty by the US as it seeks new nuclear weapons?

I think this is tied together by the incredible privilege and responsibility we have as citizens of the United States. We elect the men and women who rubber stamp or do not rubber stamp what the president wants. We elect the most powerful figure in the world. He is accountable only to us, the electorate.

Several days after the last election I got a letter from a dear friend in Lima, Peru, Bill Monning. He is a lawyer and co-founder of the Salvadoran Medical Relief Fund. Bill related his conversation with a taxi driver, who told him, "Everybody in the world should be able to vote in your elections since your government controls what happens in the world." Bill then spoke of 'the global majority' who are not unlike most of the people DGH works with throughout the world. What follows is what Bill called his 'post-election rant:'

"Living at poverty or below. Unrepresented by political parties or incumbent governments. The global majority is working to survive, uneducated, without political power, and without voice. We should regard them as our allies who deserve to be heard, to be included in the division of the global pie, globalization's dispossessed. Give them all the vote. Send the exit poll experts into the field. Conduct some exit interviews when workers leave the gold mines, the sugar plantations, the textile sweat shops, the high tech assembly lines, and the subsistence farmer's waterless plot of land. Ask the global majority whether they favor tax cuts for the rich or education, abstinence or family planning. Ask the surviving family members of innocents killed by precision smart bombs or car bombs if they favor more war like the massive assault about to begin in Fallujah or do they support negotiation and mediation that could lead to an American exit from Iraq.

"Give them each a vote, give them all a vote, expand democracy, build democratic institutions, expand the franchise. Include the immigrant workers forced to leave their families to cross armed borders as economic refugees. Since they can't vote, convince your dispirited colleagues to link arms, keep marching, and pretend they are voting for them...We cannot rest, the global majority never rests, the working people only dream of rest."

Whatever else we choose to do in life, we must attend to and take seriously our responsibilities as citizens in the global super power, because in reality we are voting for the disenfranchised of the world.

I want to share a few words with you that sustain me in times when I am feeling overwhelmed. They were sent to me from someone in the West Bank as the war with Iraq was about to begin. I was distraught that we had not been able to quiet the drums of war and that 'shock and awe' was commencing. These words are from the Talmud: "Do not be daunted by the enormity of the world's grief. Walk humbly now. Do justly now. Love mercy now. You are not expected to complete the work, but neither are you free to abandon it."

— Excerpted from the keynote address given by Dr. Charlie Clements at the DGH Tenth Anniversary General Assembly on August 6, 2005, at Columbia University, New York, NY. Read the full text.

Dr. Clements is a public health physician and a human rights activist. His MD and MPH are from the University of Washington, where he's a Distinguished Alumnus of the School of Public Health and Community Medicine. Dr. Clements has been widely recognized for his humanitarian efforts working as physician in a 'free fire zone' in El Salvador during the civil war. He has served on the boards of both Physicians for Social Responsibility (PSR) and Physicians for Human Rights (PHR). He represented PHR at the treaty signing in Ottawa and a week later at the Nobel peace prize ceremonies is Oslo for the International Campaign to Ban Landmines. He is the author of Witness to War, (Bantam, 1984) and subject of an Academy Award winning documentary of the same title. He is currently President and CEO of the Unitarian Universalist Service Committee in Cambridge, Massachusetts. Earlier in his life he was a Distinguished Graduate of the United States Air Force Academy and was a pilot in Vietnam until he was discharged because his conscience led him to refuse to drop bombs on Cambodia.

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