By Brenda Hubbard |
This is all too common in our repopulated communities. Every month I hear of a baby born with either congenital heart disease or weak lungs, prone to respiratory disease, or even malformation. Every month in our Centro de Rehabilitación, health promoter René Beltran treats newborn babies for respiratory illness. Why? For a population that does not reach 5,000 in our five communities, the statistics are overwhelming.
| “A 12-year-old can buy the most toxic agrochemicals imaginable. These same children, with no protection, are sent to work spraying the poisons.” |
This means that the government of El Salvador is educating an entire generation with only enough skills to enable them to work in the maquilas, the sweat shops.
Our rehabilitation center is located in the Cantón of Santa Marta, in the department of Cabañas, in the northern mountains just east of the center of El Salvador, where the Rio Lempa borders Honduras. There are five communities here that have been repopulated by the same people who were driven from their homes by the military during violent government repression in 1981. These people, after loosing everything, lived in refugee camps in Honduras for up to ten years. When they returned to the land where their umbilical chords are buried, war was still raging in their mountains. Their lands had been raped of their trees by men friendly with the government, who sold the wood for profit. They returned to nothing and with nothing. Survival dictated that they cut trees to get shelter over their families' heads.
People work the lands, farming for their basic food needs: corn and beans. In the 70's pesticides were introduced and now people do not believe they can grow their food crops without these toxic poisons. Twelve-year-olds can hop on a bus or cattle truck, go to the agroservicio store in Sensuntepeque, capital of Cabañas, and buy the most toxic agrochemicals imaginable. These same children, with no protection, are sent to work spraying the poisons.
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| Health promoter, René Beltran, with a young patient in front of the Centro de Rehabilitación in Santa Marta, El Salvador. |
The entire population is exposed to these deadly poisons. We breath them in regardless whether we work the lands or not, because we are surrounded by agricultural lands.
To make matters worse, the poisons are not working as well as they used to. There seems to be resistance building in the weeds. So now they mix several of the herbacides together. This is not something people are receiving any formal training in. They simply buy the poisons and experiment, hoping these combinations will give them the effect they need.
Meanwhile, the Santa Marta Clinic, our Centro de Rehabilitación and even the Hospital in Sensuntepeque, are attending daily to our community members with acute respiratory disease.
DGH volunteer Masaya Koto, who has a degree in Public Health, came to Santa Marta to do a qualitative investigation of pesticide use and abuse. This is very exciting for us and a long time in coming. It is tragic that the government of El Salvador has shown no will to improve these environmental health hazards. There are several very active non-governmental environmental agencies advocating to bring change at a governmental level, but their efforts fall on deaf ears. So it is up to us to do these studies and support their efforts.
Other environmental health hazards we face include the animals that run loose in our communities. Of course, everyone has to have a pig or two, some goats, perhaps a cow and even horses. The animal feces is a huge contributor to our critical health concerns. To add to that, there has been no plan for the garbage since folks first returned here in 1987, so we are now living on top of a garbage dump.
An Environmental Health proposal has been developed by the local NGO I volunteer with, ADES (Asociación de Desarrollo Económico), but has yet to find funding. They are making efforts to implement the basics for treating garbage. They have been working with youth in our communities who have identified the garbage crisis as the most urgent problem we need to confront.
The youth in our communities are beginning to organize and have a voice. Extremely intelligent, they are identifying the roots of our health problems. They hold the future of our community development in their young hands and have the energy to work towards improving living conditions. Our biggest challenge is providing them with adequate health care. With all the environmental health hazards, their immune systems are constantly working overtime. If the roots of our health problems are not confronted we will never improve the quality of health and peoples lives. If children can't receive an education because of their poor health, their standard of living can never improve.
For many years we have concentrated on the curative aspect of health. Now it is time to make preventative medicine a priority. Do we merely put Band-Aids on our health problems, as the Ministry of Health continues to do? Or do we also start implementing preventative measures to improve the health standards of the community as a whole?
| “The youth in our communities are beginning to organize and have a voice. They hold the future of our community development in their young hands and have the energy to work towards improving living conditions.” |
Another international NGO just finished an integrated health project in Santa Marta. They built latrines, are reforesting a small area and brought water to the houses in the communities of Santa Marta and Valle Nuevo. DGH has also contributed to water being piped into the Center and a pila (cement tub that holds water) that is being built. At long last our rehab center is going to have water. In the 10 years I have been working here, this will be the first time we have an indoor water supply.
Three years ago the community of Santa Marta made a decision to hand over responsibility of its clinic to the Ministry of Health (separate from the rehab center). It has been difficult to say the least. A short while back the director of the clinic is a young woman doctor who is doing her año social (year of community residency), with absolutely no supervision. Not long ago antibiotics came close to their expiration date and, instead of returning them to the Ministry of Health, the doctor chose to hand them out to school children with runny noses simply to use them up. Health promoters and a few mothers reported this. The director of ADES and I went and met with her to confront this abuse of antibiotics and also prevent further abuse. The doctor was quite upset until we explained that we did not feel it was her fault. She should never have been expected to do her residency under such extreme conditions with no professional supervision. Witness to the abuse of antibiotics were DGH volunteers Bina Patel and Becky Blankenburg, who spent a month with us last year before beginning their residency in the US.
Another DGH volunteer we are very grateful for is the vibrant and brilliant Denise Zwalen, PA, MPH. She spent three months with us during those first difficult months of the earthquakes (January-April 2001), and now has returned for another six months here. Denise is an angel sent to us to provide health care to the community, work in the clinic and befriend our health promoters. Denise worked with our promoters in health brigades that went to earthquake-affected villages and attended those who were so sick. She also organized several activities and outings with the health promoters.
- Brenda, a physical therapist from Oregon, opened the rehab center ten years ago. She has funded it, in part, by working as a translator and guide to groups visiting El Salvador.
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