Took the Clinic

Exif_JPEG_PICTURETuesday morning at 7:30 the doctor at the Eco Familiar in Guajoyo was scheduled to arrive to see patients.  As per usual, he showed up over 2 hours late, only to find a crowd awaiting him at the entrance, the gates chained closed, and a sign that read: “In agreement with the four communities, we will not let the doctor pass due to mistreatment of his patients and irresponsibility.  We deserve to be treated with dignity!”

Don Pablo explains the community's perspective to Dr Cabelleros

Don Pablo explains the community’s perspective to Dr Cabelleros

This was not the angry kind of protest where people yell things and badmouth; it was calm and dignified, with a selected delegation of people to discourse concisely the concerns and demands of the communities.  The demand was simple: that he turn in his key to the clinic and not return.  With the support of the head doctor for our region, the now-ousted Dr. Caballeros turned in his key, gathered his things, and rode away in the Ministry of Health’s pickup truck.  Unfortunately, I believe he will simply be transferred to another community, even though in the viewpoint of these four communities he is not suit to work as a doctor in any clinic in any community.

Nina Blanca was among the first women who showed up to demand dignified treatment at the EcoFamiliar

Nina Blanca was among the first women who showed up to demand dignified treatment at the EcoFamiliar

In a country where corruption is widespread, favoritism in well paid positions is rampant, and classism that places professionals above the normal person, these kinds of collective actions are often necessary.  It is simply part of the way things work that a strike is more effective than a well thought-out letter, or problem-solving meetings. But that doesn’t mean in a different context the same kind of actions aren’t necessary.  In the US, there are certainly public employees who don’t do their job well, doctors who mistreat their patients, and other functionaries who overstep their power and lack respect toward the general population.

The difference is that we in the US have great faith in the bureaucratic process, that process of “I’ll pass this along to the appropriate powers.”  And sometimes that’s really great, and our bureaucratic processes function a lot better than many of them here in El Salvador do, but that same faith can also blind us to the civic duty to react, to do something ourselves and not wait for someone else.

Dr. Cordoba, who is the regional head doctor and boss of Dr Caballeros, showed up to resolve the situation.

Dr. Cordoba, who is the regional head doctor and boss of Dr Caballeros, showed up to resolve the situation.

The same thing happens here, and although the activity on Tuesday morning was a success in many ways, it was also disappointing.  The four communities served by the EcoFamiliar are made up of over 200 families, each family usually consisting of 6-9 individuals.  Yet at the strike, only about 50 showed up to take the clinic and demand dignified treatment.  Community leaders face this frustration more and more as people get comfortable, and as their needs feel less and less urgent.

When El Salvador was in the throes of the armed conflict, people often could not get food and would go a week without eating.  People’s homes were bombarded and they were left with only the clothes on their backs.  Family members disappeared, children were kidnapped, sons left to serve in the guerrilla, and other forms of loss and familial disintegration.  People felt the need to demand their rights, they felt the need to show up to meetings, to work together.

Now, many of those families live in houses that keep rain and animals out; they do not fear bombs being dropped on them at any moment; they are able to do normal things like send their children to school, do the laundry, and make tamales.  Mostly, these things are thanks to the hard work and organization of community leaders.  But sometimes, these things come as handouts.  And these handouts create a culture of “assistance-ism”, the disappearance of motivation to work for the common good, the expectance for things to be given freely without a counterpart of work and commitment.

It’s complex, because on the one hand there are basic needs that are being met by these ‘handouts’ – houses, shoes, basic grains – but on the other hand, without the involvement of the people being benefitted, they can actually become very disempowering.

That’s why Sister Cities works through CRIPDES, whose focus actually isn’t projects, it’s community organization.  So when a funder shows up to do some sort of project – whether it be building houses, installing a community bakery, or giving out agricultural supplies – we go through the community structures in order to find out what the community’s needs are, and to figure out what will be the community’s counterpart.  Will people volunteer their labor to build the houses with donated supplies?  Will individuals dedicate themselves to the maintenance of the donated equipment?  Is the project something that the community itself has solicited?  Because that way the community becomes the owner of the project, of its success or failure, and it is clear from the beginning that without continual hard work, the project will not thrive.

It’s not perfect, and we don’t always do solidarity well, but it is the model we follow, the goal for which we aim.  Because it is the organization and the active participation of community members that will carry communities like Guajoyo into the future.  And that is the tireless work of the community leaders to inspire, to encourage, to educate, and to reach out to an increasingly comfortable population in an effort to never forget that a healthy community is built by active participation of each of its members.


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