A Tale of Two Hospitals

This is a reflection about my visit to the private hospital and then the public hospital of El Salvador all in the same day with students on our delegation from Eastern Michigan University.

If you only went to the Hospital Diagnostico, you might not be able to relieve that a hospital like Rosales existed in the country and vice versa.

We went to the Diagnostico first and were given a tour by one of the young residents. Her English was quite good and she was incredibly friendly and helpful. We moved through the cool rooms with the artistic Salvadoran paintings, nice floors, and clean facilities. The hospital used to be a mall and you can see by the set up, do to this unique architecture, specialists are able to have their own offices. We were able to visit the room with one of the only MRI machines in the country and we peaked into the quiet ICU.

The patient rooms were individual rooms with private bathrooms, nice furniture and plasma TV’s. On the fifth floor where the rooms where oldest, the TV’s were not plasma but the view of the city from the balcony was amazing.

In the waiting room we watched as a small boy in overalls was whisked in by his nanny with a cut finger. He was immediately seen by the doctors. As we visited the emergency, the boy cried as they cleaned his finger. His young mother and father had entered and his father comforted him: “Don’t cry, this weekend we will go back Apaneca and you can ride horses again, wouldn’t you like that?”

We finished the tour, thanked our young doctor and headed to Mr. Donut for a quick lunch before arriving at hospital number 2.

It is hard to put the experience of Hospital Rosales into words, but I’ll try.

The chief of residents who took us around the hospital also spoke English. He had studied a semester in the hospital at Yale, so he must have had some concept of the vast ocean that existed between a private hospital and the one he worked at.

Rosales was various buildings. Many of which are the same as when they were build in 1904. The beds in all the wards were full. The first wards were giant high cieling rooms with about fifteen beds in each. We walked into the room for people with kidney failure. A resident was pumping air into the lungs of a patient for lack of a breathing machine. It was hot and there was no AC. Hospital staff moved around from one person to another. Some family rubbed the backs of their family who grimaced in pain.

The AIDS ward was similar.

The Emergency room was a horror. Full of people who looked as if they had come from the most remote corner of the country. Bent over, coughing, with homemade bandages. Some people leave their homes at 3am to arrive here the doctor said. They usually wait on average 4 hours before they are seen. People who need a bed sometimes wait three days. If there are no beds, they roll out towels on the floor while they wait for a doctor.

The OR had about 6 patients many of whom looked gravely, gravely ill. A man in a chair who was not able to have a bed do to the lack of them, explained to a nurse the pain in his chest that was probably a heart attack.

As we reached the nicer wards, the ones with air conditioning, but still very evident of Salvadoran poverty. We saw where the flu patients are kept. One girl in our group asked: why do you give the nicer rooms with AC to the people who aren’t as sick? This may be hard to hear, the doctor said, but we have very few resources, we have to prioritize. Many times we give priority to the people who are younger who have a better chance of living.

We walked on. This is one of the few public, full scale hospitals in the country, he told us. It is free, that is why people come all over. Most of them have to ask for a dollar to get back to their homes. We ourselves don’t have the resources to have enough doctors or enough medicine. We have a whole ward build by the government of Germany in disuse because we don’t have enough Money to pay the staff. When we do open it, we will give it to patients with renal failure, a very common illness here—it’s the farmers who get it, the ones who have been poisoned by the pesticides.

We walked on, sick person after sick person. We reached the end and thanked the doctor. He thanked us. Now you see, he said, the difference between private and public hospitals.

Like I said. Had I just gone to Rosales, I couldn’t have believed that a place like the Diagnostico existed. And vice versa.

Back pain

This is a reflection on the week in June that I spent as a medical interpreter at the clinic at Maria Madre de los Pobres Catholic Church in La Chacra, San Salvador. The medical professionals who I interpreted for come to El Salvador everyone on a SHARE delegation from Visitation Parish in Kansas City.

She was a street vendor who walked around carrying a giant tub of juice cans. The pain in her heals was unbearable.

He threw his back out six years ago. He still has horrible pain. He thought it was cancer. But really it was the fact that he lifted tires everyday and put more and more strain on his back.

She lost her arm during the war. Her husband just had a stroke and is paralyzed, she now does everything for him and work to support them. She can't sleep from back pain.

She was hit by a motorcycle two years ago. She and her daughter and grandson received death threats until the boy fled the community. They cried when they talked about being afraid. They both have knee and back pain.

She didn't know that there is no pill for her mother's alzheimer's. I explained it to her as best as I could.

His knees are shot from arthritus. But he needs the factory job, and so he continues to climb up steps and lift stacks of metal plates.

She can't afford the medicine for her Parkinson's. She came to see if we would give her a cane.

One by one, they sat down with us. Soy Laura y voy a traducir. Supposedly a translator is just a tool for the doctor, but the pain they carried stuck to me and I couldn't forget after they left. Everyone was carrying some kind of pain. We taught them leg, knee, back and neck exercises. To strengthen and stretch. To give some relief. Something that could possibly be more sustainable to a pill. We were able to give some of them canes. We hoped it would work. But we couldn't give them new shoes, new floors to walk on or beds to sleep on. We couldn't give them access to a swimming pool to do their exercises. We couldn't give them new jobs or new homes. We couldn't take them out of La Chacra and the poverty and violence. We could teach some breathing techniques but we couldn't take away the stressors.

On Friday, after all the patient visits, we went with the group to the UCA to see the sacred site. On the wall there was a drawing I had never seen on previous visits. Stick figures going through their day to day life. Working in construction, repairing cars, walking through the market. Each one was drawn with a cross on their back. The cross that the poor person carries as they go through their day. No one is going to give them a break, a win. The cross gets heavier and it weighs them down. No wonder they all have back pain.