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Our last entry was a little over three months ago. We had just returned to the States, the Christmas holiday season was upon us, and we were just starting the process of figuring out the next steps in our journey from lay mission in the field to the work of “reverse mission” here at home. A lot has happened in those three months both here and in Chiltiupán. In January FMS sponsored a three week reentry retreat program for the recently returned lay missioners. It was an opportunity to reconnect with the other members of our group (from our original formation program in 2004) and in a quiet, prayerful space look at the past three years and the experiences as a whole. We also examined the changes that had taken place here in the US in those three years – and started to identify some of the aspects that we must deal with as we get re-established in the US and started to discern what reverse mission would look like for us. Just as we began the retreat process we heard from our friends in Chiltiupán about the devastation caused by an unusually violent wind storm. Many homes were destroyed or damaged by the winds; the town was without water, lights and phones for several weeks. Part of the school’s roof was blown off and school was delayed in opening for the new school year by several weeks. It was frustrating to know what was happening and not be there to help, but it also pointed out to us the friendships and connections we made there are binding and that we’re still called to respond to the needs as best we can from here.

In the weeks following the retreat we started the process of getting settled in the area, close to our children and grandchildren. We found a small townhouse in Maryland in a very diverse neighborhood. I think there will be lots of opportunity to keep up our language skills – and learn a few others if we want to! Now that we’re living in Maryland instead of Virginia where we lived for 35 years we’ve also had to work at what a friend of ours calls “building the infrastructure of your live” – finding the best grocery stores, getting to know the roads and shortcuts, finding a dentist and doctor as well as the more important things like getting to know your neighbors and finding a good parish. In short doing what needs to be done to become a part of the community. Like most things for us now it’s a process and we are learning as we go. We moved into our new home the end of February and are more settled each day. Several neighbors came over last week to officially welcome us to the neighborhood and they gave us a good orientation to the areas that are new to us.

Now that we’re finally getting settled in here we’re making plans for a return visit to El Salvador and Chiltiupán for the first part of April. We’re going to assist with a medical brigada in Chiltiupán that is sponsored by the Cleveland parish of St. Dominic’s. They are bringing 15 medical providers and plan to do medical consults and treatments for three days straight. In addition Sister Sharon, the new director of FMS will join us for a week. We will visit with Beth, the FMS missioner at Calle Real as well as help Sister Sharon get a good overview of El Salvador and the mission opportunities there. Finally, we plan to visit friends, former co-workers and catch-up on all that has happened in the past few months. For starters we know that the police arrested several people responsible for the break in at the school (see prior entry), and the stolen computers were replaced by a friend of Fr. Rob’s. However the internet connection that was damaged during the wind storm in January is still not fully repaired and is intermittent at best – but work continues in this area. As for the clinic, the community support group has been very active in looking for ways to support the work both with fundraising activities and in-kind support. I am looking forward to seeing the clinic staff and the people that I came to know through the work in the parish clinic. I think it will be a busy three weeks.

So the question remains – what next for us? How do we continue to nourish the relationships that we developed over the past three years, foster new relationships especially in areas of social justice here in the States as well as participate more fully in family life here? We don’t have a road map for all of this but are confident that the way will become clearer to us with time. Over the past three months one thing though has become very clear to us – the negative feelings toward immigrants. An issue that is complicated and complex has been reduced to sound bites and misinformation. For starters there is no real discussion on the reasons that drive so many to leave their families, often with the prospect of not returning for years. We now see many undocumented immigrants living in fear- fear of being caught and deported, fear that even with the risks they took to get here, they will not be able to provide for their families back home that are depending on them for survival. How we will become involved in this issue is still unclear but I do think we have a perspective to offer and something to say. We do know, however, that after the privilege of these past three years of living with Salvadorans and sharing both their daily struggles for survival and their successes, we owe a great debt. Their faith has strengthened ours and we hope to use that new found strength to continue to respond to the needs of poorest and those without a voice. At this time and in this country the undocumented immigrant is indeed voiceless.

We started this “blog” 3 1/2 years ago as a way to stay in touch and share some of our experiences during our three year commitment as lay missioners with Franciscan Mission Service. It was a way for us to let family and friends share in our journey as well. While we won’t be living in El Salvador as before that experience will always form a part of our lives as we look to how we will live out the challenge of “reverse mission”. We will not be making any new entries in this blog but will leave it and the archived entries posted for several months. We’d like to thank the many friends and family members who shared in our experience either through donations to support FMS and our work with the school and clinic in Chiltiupán, reading the blogs and offering your comments or visiting us in El Salvador. Thank your for your support and sharing these past three years with us. ;

Paz y bien – peace and all good,
Pat and Don

Below are some pictures taken over the past three months- Our FMS group of returned missioners with FMS staff during the re-entry retreat; Pat enjoying a moment with our youngest grandson, Ethan; Jackson at his birthday party (3 years old) – can you tell the theme was “firemen”?

FMS Return Missioners and Staff January, 2008 Pat and Ethan Jackson Driving Fire Truck!]]> General http://donpat.com/index.php?itemid=74 Sun, 23 Mar 2008 15:31:51 -0400 http://donpat.com/index.php?itemid=73 TRANSITION

The past three weeks as we’ve continued our transition from lay missioners in the field to lay missioners with a focus on “reverse mission” have gone by all too quickly. Leaving Chiltiupán was harder than we had imagined. These past 6 months we had worked to make a smooth transition – Don had updated the computer lab and installed their first brand new computers bought with a generous donation from friends. I had been working with the doctor and clinic staff to orient the new nurse so she would be ready to take over the nursing areas in the clinic. We had both been working with community volunteers to finish the clinic’s accounting and pharmacy inventory control program. And we almost made it!! The things that still need to be addressed are now in the hands of community/pastoral de salud volunteers and those who work at the clinic and school. We hope in the future to be able to support them in some way as they move forward in both the areas of health care and education.

I guess you could say the last two weeks in Chiltiupán (we left November 30) were bittersweet. The bitter part came when we were awakened early Saturday morning to the news that the school had been robbed. A very organized group (at least we think it was a group) managed to break the huge padlock and chain on the fence, pry off the security bars that covered the windows to the principal’s office and the computer room. The robbers went straight for the 3 new computers, a lab top, the school’s media system (TV, sound system, VHS, DVD player). Everyone in the town was stunned – the night watchman slept through the robbery, the policemen who are only ½ block away didn’t want to come investigate at all – took them two hours to make it up to the school. Everyone seems to think it was a job based on inside information if not actually carried out by someone in the town. These kinds of robberies are all to common in the city but it was a real shocker to have one happen in a municipio as rural as Chiltiupán. After the initial shock everyone is starting to regroup and look at how perhaps to trace the computers, replace the stolen goods, and have better security at the school – although the security was already better than average. Keep the students, teachers, the administrative staff and all those who work so hard to support them in your prayers. As one person put it – the robbery didn’t just take valuable goods, it also was a robbery of future learning affecting all the children of the school.

Now for the “sweet part” – the community support group (like a Community Advisory Board) that we had been working with for the past three months to complete the parish clinic’s written plan for the coming year arranged another despedida. This one had a special twist. They arranged for a bus to pick up Don and I and all the committee members and transport everyone to a small restaurant on the beach for a dinner and final farewell. The food was delicious, the scenery was beautiful with a gorgeous sunset, and the memories that we have are the best part of it all. We plan to stay in touch with this group as they are the ones who are taking on the hard work of keeping the parish clinic going and true to its mission.

The last week in Chiltiupán found us “redistributing” our goods. We had lived a pretty simple life but still since there won’t be FMS replacements for us in Chiltiupán, we needed to find a home for most of our things. Much of our furniture went to furnish an apartment for two new Maryknoll lay missioners, a couple, who will be arriving in San Salvador in December. Some of it also went to clinic and the “casas de salud” in the more remote cantones. Ticho, one of the lead health promoters, was especially glad to get a sturdy table for the “casa de salud” in Siberia. It will help improve the storage and work areas.

We said good-bye to the town one last time on Friday, Nov. 30 with the promise it wasn’t “Adios” forever, but only “hasta pronto”. Our good friends the Palacios not only helped us with the final packing, but also with getting to the city and took us in for the weekend. Transitions are difficult and sometimes it’s hard to find the right place to “stand” while you’re in the midst of it. The Palacios who have been friends, supporters, co-workers, and at times counselors during these past three years also helped us with the transition. It was as though they as our Salvadoran family helped us cross that bridge and reunite with our North American family. We spent a relaxing weekend with them and then they took us to the airport on Monday, December 3 for our return home.

We are now spending the days getting acquainted and reacquainted with our grandchildren, our children, family and friends. The holidays will be a challenge not only for the weather but also for the emphasis on all the material things that is hard to escape if you live in the USA. We are looking forward to the re-entry retreat at Franciscan Mission Service in January as it will give us a chance for deeper reflection on the experiences of these past three years and perhaps help us more clearly discern our path for our “reverse mission.”

For now we want to wish all those reading this a “Feliz Navidad” and peaceful new year.
Paz y bien
Pat and Don

Below are some pictures of our final days in Chiltiupan – the beach despedida, Ticho as he heads to Siberia (2 hour walk) with the new table for the casa de salud, the Palacios and visit to one of El Salvador’s national parks. Finally a poinsettia, from a plant native to Chiltiupán.

Despedida "Ticho" carrying the table to Siberia Our Salvadoran "family" - the Palacios The Poinsettias of Chiltiupan]]> General http://donpat.com/index.php?itemid=73 Mon, 10 Dec 2007 14:20:35 -0500 http://donpat.com/index.php?itemid=72 NOTE: PLEASE DO NOT SEND ANY MAIL TO OUR SALVADORAN/MIAMI ADDRESS. THAT MAIL SERVICE IS CANCELLED SINCE WE WILL GOING HOME TO THE WASHINGTON, DC ADDRESS - ARRIVING DECEMBER 3RD.

Chiltiupán – some thoughts on the past few weeks

It’s been over six weeks since our last entry and so much has happened that it’s hard to know where to start. Probably starting where we last left off would be a good idea! “Maria de la Tormenta”, whose real name now is “Sofia de Los Angeles”, had a very dramatic entry into the world and her first week she spent in the hospital under observation while her mother spent several days in the ICU - they were in different hospitals. Sometimes it’s a little hard to follow the logic of the health care system here but the bottom line is that both have now been discharged, Sofia is gaining weight and is now up to 6 lb and seems to be doing well. Vilma, her mother, is slowly recovering, she’s still quite anemic and she has several follow up visits with specialists to make sure there aren’t other underlying problems that caused the premature birth and all the other complications. I think they both have lots of “angels” looking after them and that’s a good thing.

It also seems like Sofia’s arrival into the world signaled the end of the rainy season here. The week she was born we were in the midst of a tropical depression with continuous heavy rains and all the things that happen when the ground gets saturated. Several people had to be evacuated from their houses due to the potential for landslides and we had small landslides on the roads but they were cleared quickly and the roads stayed passable. By mid October the rains stopped and things started drying up again. We’ve now had almost a month without rain and things are even starting to turn brown on the hillsides.

It was a good thing for us that the dry weather came when it did since we had planned a medical brigada to Siberia Norte for the end of October. The “roads” into Siberia Norte were washed out from all the rains of the past few months – some weren’t even in good enough condition to merit the name of “road”. That meant that we had to walk in – the hike in takes about 2 hours and is pretty much all downhill which means that the return trip is all uphill. (Believe me, when I say “uphill”, it’s truly UPHILL coming back from there.) When we arrived at about 9:00 the health promoters from the community already had their committee organizing the activities for the day. We just had to set up our work stations. It was a good feeling to see such team work through the day. The clinic staff and our group of volunteers have all worked together on these “medical brigades” so often over the past three years that this one just seemed to flow smoothly. In all we were able to see about 80 people that day and arrange for another 20 women to get their female exams at the clinic during the following week – not bad for a day’s work.

This was also a special brigade for Don and me since it’s the last one we will be doing as FMS lay missioners and Siberia is one of the communities we’ve worked with on a number of occasions. We’ve come to know the people there as friends and colleagues and have been privileged to share in their lives and come to know their stories. Most live in conditions of extreme poverty but truly embody the gospel message of “love of God and love of neighbor” by their daily actions. They have often been the ones to show us the way and working with them has been a true blessing for us and we’ll miss them greatly.

As we near the end of our three years here these past two week have been a time of formal and informal good-byes. Here in El Salvador when one leaves for a long trip it’s traditional to have a “going away” party or “despedida” and we have had several already. The school, all the classes K-12 and staff, invited us to spend the morning with them and we felt like royalty. They made us sit in a special place and each class did something special to celebrate our time here in Chiltiupán. There were songs – traditional and original ones, dances, original poems, and special marimba music played by the local musicians. The best part was all the hugs from the children after they finished their piece. There’s nothing like the spontaneous hug of a child to make your day.

The parish also arranged a special mass on Nov. 4. We were able to celebrate in a special way with the community that has become a part of our lives. After the mass was over different groups and individuals made small presentations telling us how we had impacted their lives. Again they had us sit in special seats up on the altar. We were really touched when the children from Siberia, about 20 of them divided into a line of boys and a line of girls came up one at a time and each presented us with a rose. Needless to say it was a day of lots of tears but also remarkable for us to look out at all the people there and see friends and familiar faces when just three years ago we didn’t know anyone here.

Just this last Sunday we were treated to another “despedida”, this one by the group of students who are studying at the university on scholarships. We’ve written about the scholarship program before which is supported by several parishes in Cleveland and by several friends who have also contributed to this fund. Most are finishing up their second year of studies and what growth we’ve seen in them. Besides doing well in their studies they are also forming a real sense of identity as a group and a growing awareness that they will soon be in a position to not only help their families but also contribute to their community. They arranged an afternoon luncheon for us and planned everything from the menu to the decorations. It was especially touching for us when on a suggestion from one of the students we closed the luncheon with all of us reciting the Prayer of St. Francis, how appropriate! We have all their emails so I’m sure we will stay in touch with this group.

It sounds like all we do is go to parties now but we have also made time for a short retreat with reflections on this transition time and getting prepared for the re-entry process. This is a tricky time trying to stay in the present here as we wind up the last of our work at the clinic and school and yet start the process of getting ready for that next stage of our Franciscan Mission Service commitment – reverse mission. Keep us in your prayers as we negotiate this new aspect of our lives.

Paz y bien,

Pat
The pictures below show: Don with "Maria de la Tormenta" weighing 6 lbs, second grade dance at school despedida, children at the church despedida bringing us flowers and hugs, marimba group at despedida, Pat at Siberia brigada.
Don and "Maria de la Tormenta"2nd Grade Dancing at School Despedida Church Despedida, children with flowers and hugs Marimba at school despedida Pat at Siberia brigada]]> General http://donpat.com/index.php?itemid=72 Mon, 19 Nov 2007 22:28:43 -0500 http://donpat.com/index.php?itemid=71
Maria de la Tormenta (Storm)

October in El Salvador and especially here in Chiltiupán means lots of rain. Chiltiupán is at the edge of a cloud forest so we often have days when the clouds descend and it’s like the town is inside a giant cotton ball – well, a little more humid than a cotton ball maybe. It’s actually has a very peaceful feel to it when it’s just the cloud cover – add the rains and then all the daily activities become a little more difficult and treacherous. This weather seems to always bring challenges and difficulties with blessings and today we’ve experienced just that. It was a coincidence of grace that all of the clinic staff as well as several of the people who work with the health promoters in the cantons were gathered in the same area.

We’ve been having heavy rains for the past 4 days (a tropical depression is over the area) and all the paths and rural dirt roads from the cantons to the town are next to impassable. People only leave their homes during weather like this for emergencies or urgent matters. One of our patients, Vilma, a young woman with her first pregnancy, started having signs of early labor yesterday. The doctor decided she needed to be seen since it was full month before the baby was due. Vilma’s father is one of the health promoters with the parish’s health ministry and works closely with the clinic. He is the one that everyone in his community looks to for health advice so he knew that if this was early labor and not just false labor it was a serious matter.

Early this morning they started out from their home in Siberia Norte carrying Vilma in a hammock stretcher. Given the weather, the slippery paths and the uphill climb the journey took a several hours. Vilma started into heavy labor along the way and by the time they arrived at the entrance to Chiltiupán she had given birth to a tiny baby girl. Meanwhile at the clinic we had been in cell phone contact with them along their journey and had the team mobilized to meet them at the outskirts of town. The doctor was able to attend to Vilma and the baby there under the overhang of a store front. We got them stabilized and transported to the clinic where both baby and mother could be cleaned and further assessed. The baby (we called her Maria de La Tormenta because she was born in the midst of a rain storm) was small (4 pounds) since she was a bit premature but otherwise healthy.

Her mother wasn’t so fortunate. Since her last pre-natal visit she had developed a condition called pre-eclampsia which puts both the mother and baby at serious risk. Fortunately Gloria, the coordinator of the health promoters and the pastoral health ministry, arrived for a site visit just as this was all happening. She joined the team effort and helped with getting the baby stable and getting the mother transferred to the hospital. There are no ambulances here so Don, using our truck, drove Vilma and the baby to the hospital with Gloria acting as his assistance. The rest of us stayed at the clinic to attend to the other patients who had braved the weather to keep their appointments.

As I write this “Maria de la Tormenta” is doing well. She is in the hospital for observation. Vilma has been admitted and is under care. She lost a great deal of blood and is not out of the woods yet with the dangers associated with eclampsia. Keep her in your prayers that she has a quick and full recovery. As for “Maria” please keep her in your prayers also – she’s had a rough introduction to this world but we hope that the love and caring she encountered after getting here will be what’s incorporated into her life.

Once again I feel blessed to have the opportunity to work with people who are so committed to serving the poorest and those most in need. The teamwork today seemed so effortless, but that kind of coordination can’t happen without a staff that not only knows what to do but works well together.

Peace,

Pat

Pictures below show baby one hour after arrival, baby with the Dr. William, and baby with Vilma (mom). The last picture gives you some idea of the climb out of Siberia where Vilma and family live. They live all the way at the bottom, and had to climb on foot in the mud in a virtual downpour for more than two hours!

"Maria de la Tormenta"Baby and Dr. William Baby and Vilma Siberia]]> General http://donpat.com/index.php?itemid=71 Fri, 12 Oct 2007 19:52:20 -0400 http://donpat.com/index.php?itemid=70 GUEST BLOG

The following are the reflections of Eileen Kugler and Liz Segall who visited Chiltiupan in August.

In late August, we had the wonderful opportunity of visiting Don and Pat in Chiltiupán. We both felt we did not want to miss the opportunity to learn more about El Salvador from the unique perspectives of Don and Pat and to see their work up-close and personal. We truly appreciated how Don and Pat graciously shared their interpreting skills, their meals and their home with us.
Our first impression was the great natural beauty of the area. Since Chiltiupán is situated on the ridge of a mountain, the views were absolutely beautiful, especially during the rainy season in late summer when we were there. During thunderstorms the noise of the rain on the corrugated steel roofs sounded like we were under a waterfall. The proximity of lightening is startling when you are literally in the clouds.

We quickly learned to enjoy the slower pace of rural life. Evenings were spent in quiet conversations, reading, or chatting about the books we had read (We all seemed to have the same reading list!) The nighttime sounds were an interesting adventure for us city folks. Who knew that roosters crow anytime they want - even at 1:30 a.m.? The dogs were particularly noisy one night – and then we realized that the moon had been full. Thus one rural legend is confirmed.

We were lucky enough to be in Chiltiupán during the annual festival celebrating the corn harvest. A procession in the street led to a service of Thanksgiving at the church. Then the festivities began. The town's farmers and families donated more than 3,000 ears of corn, which were turned into tamales, corn fritters, and a sweet, hot drink (atol) made with corn, milk, sugar and vanilla. Corn on the cob was served on sticks with ketchup, mayo, and/or mustard. Entertainment ranged from traditional dances performed by locals of all ages to town elders performing on a large marimba.

Throughout the festival, and the entire week, we could see how Pat and Don have become such special members of the community. We were honored to be their guests. We’d glance over and see Don talking to one of the students he had taught, a recipient of one of the scholarships he had helped raise. And Pat would be dancing with the children one moment and providing support and medical advice to a grandmother the next.

One of the highlights of our week was the chance to meet the health promoters who work in Chiltiupán and the surrounding areas. We were struck with the diversity of the group, including young single women, mothers carrying babies, and men of varying ages. They were all volunteers – some with 10 or 11 children at home -- who took time out of their busy lives to help improve the health of their neighbors. Gloria, their leader, was the essence of an effective community advocate. We were thrilled to see some of the medical supplies we brought with us from the U.S. distributed to these hard-working volunteers for use in their communities.

Sustaining their work

During our time there, Pat and Don were busy trying to build the infrastructure that will help make their work sustaining. The impact of their work was very clear. The computer lab that Don created is now one of the student’s favorite activities. They crowd around the computers to gain access to new information and insights that were closed to them a year or two ago, including a screen saver that is a Google Earth view of Chiltiupán. Don has been working to make sure all the computers are working smoothly and the server is operating. He’ll be using some of the recent contributions to purchase good quality printers for the lab.

Pat’s work at the clinic is truly life-saving. The government health-care system is extremely difficult to navigate for the residents of this rural village, and many services require an expensive and time-consuming trip to the port or San Salvador, sometimes more than once. Not only does Pat work with the doctor and see patients on her own as a nurse practitioner, she is also using all of her skills as a social worker to support each individual and help them navigate the turbulent system. It appeared to us that Pat knew the health issues of every resident and their extended family in the entire region, and had played a part in trying to improve each of their lives.

While we were there, the clinic hired a new nurse, an enthusiastic local resident, and was restructuing to take advantage of the different skills and abilities of the ongoing staff. An advisory committee of local residents was meeting to help build more support for the clinic. We were pleased to have a small role in helping develop a system to keep tabs on the clinic’s phamaceutical inventory. These management improvements are a critical foundation for gaining additional outside funding sources for the clinic in the future.

El Salvador and the U.S.

Of course a visit to El Salvador at this time had to raise issues of immigration to the United States. Northern Virginia, particularly Herndon and Prince William County, are making international news with their crackdown on undocumented immigrants. We were struck by Pat’s insight about growing up in the Appalachian region of Kentucky and having the option to move to other parts of the United States where the economy was better. Where can you move for better opportunities if you were born in El Salvador? There are more jobs in the cities, but still not enough. We met the Clausens’ wonderful friends Rubidia and Felix and their daughter who had just earned a degree as a chemical engineer. She and her classmates are struggling for jobs, with her friends all going to the same interviews for the sparse positions.

The impact of the funds sent by Americans to their relatives in El Salvador was evident everywhere. Sometimes it enabled the family literally to survive, sometimes it meant a roof over a kitchen, sometimes some new clothes with American business logos. One searing memory was a visit Pat brought us along on, to the home of an 80+ woman living alone since her daughter died of cervical cancer (whom Pat had written about earlier). Although other relatives attempted to help the woman, she preferred being on her own. Pat brought her some warm atol from the corn festival and checked on how well she was taking her medication. But the conversation took a downturn when the woman reported that her grandson who had been sending her money from the U.S. was recently deported. His wife was from Honduras, so she wasn’t sure where they were now living. His financial support had been a critical piece of her ability to live alone.

The trip was eye-opening in so many ways, as travel always is. We’ll remember the friendly people and their joy in day-to-day life, the beauty of the Salvadoran mountains and flora, the heroes of the civil war and commitment of so many volunteers to rebuild their country today. And we’ll remember the lasting impact two individuals can have when they are committed to improving the lives of others.

Eileen Kugler and Liz Segall

The first two photos below are from the corn festival. The third is the health promoters meeting.

Corn Festival Corn Festival Health Promoters]]> General http://donpat.com/index.php?itemid=70 Tue, 25 Sep 2007 23:06:51 -0400 http://donpat.com/index.php?itemid=69 UPDATE FROM CHILTIUPÁN

We have written several times about the students from Chiltiupán who are studying in university on scholarship. Antonio graduated two years ago and gained admission to the Universidad de Central America Simeon Cañas which is one of the most academically respected schools in the country. He was in his second year majoring in computer engineering. This past semester he had been struggling with some of his classes and was disappointed with his grades. The semester ended mid-July and we soon heard via the grapevine that he had decided to “go north”. He had not discussed this decision with us or any of his fellow students. We learned from others that his two brothers who live in Houston convinced him that he needed to come north to work and send money back to Chiltiupán to help support his mother and sister as they had been doing for several years. They told him it was now his turn. He somehow made it safely to Houston and is now working for $8.00/hour but dealing with all the issues that face an illegal immigrant. It was a disappointment that he left but even a greater disappointment that he did not discuss it with anyone so that there was at least a chance to help him look at alternatives. This is a good reminder that the scholarship alone isn’t enough in many cases to help these students achieve their goals. The moral, social and academic supports all play a role here.

On a more positive note we have an update on the progress of Marcos. Marcos is a very engaging 8 year old who several months ago received hearing aides for the first time (See entry Archives May 5, 2007). The hearing aids worked great but speech therapy was essential to help Marcos catch up with his verbal skills. We could not find anyone with the skills to work with him and help us develop a plan to aid his speech acquisition. The only specialized therapy available is in San Salvador and requires overcoming many barriers to access it. We weren’t sure what the next step would be when during the last two weeks of August a small group of teachers from Spain arrived in Chiltiupán to work with several school projects here. Two of the teachers just happened to be speech therapists who work with young school age children in Spain. Pat talked with them about Marcos, and after an evaluation of his situation they developed a written plan for those here in town who will be working with him. The clinic staff, his teacher and mother will work with him on specific drills and practices over the next few months. They even bought specific material just for these sessions. Marcos is very bright and we have no doubt that his speech will improve greatly with this plan. It was an “amazing grace” coincidence that these therapists would appear when most needed!

One look at the calendar reminds us that our time here is growing short. Things are coming together with Pat’s process of transition out of the clinic since we will be leaving in December. We have spent many hours working with the doctor here developing a support/advisory committee of citizens from Chiltiupán to help make the clinic more sustainable and offer guidance and integration into the parish as a “parochial clinic”. The group now has 14 members who are working diligently on a strategic plan for the next 5 years and are committed to supporting the clinic locally. This should help with the search for more permanent funding. In addition today (September 3rd) was the first day of work for the new nurse who is replacing Pat. Cecilia is a recently graduated nurse who lives in the municipality of Chiltiupán, down on the coast. She is accustomed to working with rural communities and has experience with the government health clinics. As an added bonus her mother is a health promoter and works with rural communities so she has been exposed to this type of health care from many different aspects. She will not be able to diagnose patients as Pat does (there is no such thing as a nurse practitioner here), but will be able to work in all other areas – triage patients for the doctor, evaluation of children under 5 (she’s had the extra training this requires here), health education, wound care, etc. Pat now has three months to orient the nurse and help the clinic staff settle into a different routine for when she is gone.

Peace,
Don

Pictures below show the new nurse (Cecilia) signing her contract and the parish support committee at an all day Saturday workshop.
Cecilia signing her contract Workshop with support committee]]> General http://donpat.com/index.php?itemid=69 Mon, 3 Sep 2007 22:55:48 -0400 "CUANDO EL POBRE CREA EN EL POBRE" http://donpat.com/index.php?itemid=68
For example Maria Victoria is a dedicated community and church worker as well as a good friend. When ever I hear the song we sometimes sing at mass “Cuando el pobre crea en el pobre” (When the poor believe in the poor”) I think of her. The song celebrates those who have so little but share what they have especially their belief that working together we can all build a better world to bring about the kingdom of God. It’s easy to see why she is one of the leaders among the women since she not only sees what needs to be done but helps organized others to respond to the need. I started working with her last year to bring the soy project to her community to help address the problem of malnutrition. That work lead to a friendship as well as a working relationship. These past few months she has taken a more active role in working with mothers of small children in a health care program focused on prevention of illnesses in pregnant women and children. Maria herself was pregnant and due to deliver her fifth child this past July. She had planned to have the baby at home since she lives in one of the more remote communities and getting out especially if one is starting labor would be difficult. She also felt she couldn’t leave her other children alone for an indefinite time and go stay elsewhere until she had the baby. Unfortunately the delivery was complicated by the fact that the baby was “breech” and what should have been a quick delivery became a medical emergency. Her remote community responded in the early morning hours and they were able to get her to the hospital (about 2 hours away once you’re on the road). They managed to save her life but the baby was still born. Sometimes there isn’t much else you can do but share a friend’s tears and heartbreak. Maria Victoria is now home and recuperating but it will be take awhile especially dealing with the emotional toll that losing a baby brings. Please keep her and her family in your prayers.

June and July have been difficult months for the whole country in terms of health problems. There has been a declared medical emergency in the western part of El Salvador due to the number of individuals (especially children under 5) with pneumonia, diarrhea and dengue. The hospitals in the city are overflowing with patients and they have run out of medications and supplies for treatments. Guess you could say that there are some unresolved health issues here. In an area like Chiltiupán we also feel the effects of these epidemics. We have had a big spike in the children we are seeing with pneumonias and respiratory conditions and likewise have been stretched to make sure they get adequate treatment. In the past few weeks we have had to refer several children to emergency centers so they could be hospitalized and treated. For us that means that we also need to find transportation and give the parent a good orientation of how to navigate the hospital system once they get there. The good part is that these efforts have given good results – the children referred have been admitted and given adequate treatment.

We also see many children with pneumonia that can be treated with antibiotics and follow up at the clinic. It’s at times like this that I’m grateful that the doctor here had the foresight to make sure we both attended a national program that was co-sponsored by the local “Catholic Charities” and several other organizations. The program trained clinicians in diagnosing and treating the 5 conditions/ illnesses that cause the most illness and death in children under 5. Needless to say two of these are pneumonias and diarrhea illnesses. Being a part of this group also assures us that we have access to the medications needed to treat these conditions. This definitely helps us respond to the needs of the pediatric population – now if only there was a program like that for adults. It often feels like we use a “crazy quilt” assortment of resources to get what we need to do the job, but crazy quilts can also make some pretty interesting designs!

Finally, I should mention that Don and I are starting a process of transition since our three year commitment with FMS is up this December. Since there will be no FMS missioners to replace us we need to make sure that our transition doesn’t leave a lot of gaps. One of the big projects at the clinic that the doctor and I have been putting off is getting the “pharmacy” in order. It’s a challenge to keep medications sorted, stay on top of the expiration dates, make sure there is an adequate supply of the essential medications – some donated, some purchased. We’ve needed a good system to tie all these components together for some time – but with the limited man (woman) power we sort of limped along with a half system. However, these past few weeks with the help of two volunteers from the parish, Abel and Carlos who both work for the local health department, and Don and Josefina, the clinic secretary, we finally have the basis for a good system. We worked most of Saturday getting things in place but it was worth it and we had some fun at the same time. This should simplify things for us in terms of keeping track of medications we have on hand and what we need to order or secure from other sources.

As we look toward spending our last few months here and preparing to return to the States I’m sure there will be lots of other transition issues – but that’s a subject for another time.

Paz y bien,

Pat
The first picture below shows Maria Victoria at a previous Soy Project, and the other two photos are us working with Carlos, Abel and Josefina reorganizing the pharmacy.

Maria Victoria on the right at Soy Project Josefina, Pat, Carlos and Abel hard at work in the pharmacy!Don with Carlos, Abel and Josefina in the pharmacy.

]]> General http://donpat.com/index.php?itemid=68 Sat, 11 Aug 2007 19:31:16 -0400 POWER OUTAGES AND NEW NEIGHBORS http://donpat.com/index.php?itemid=67 Radical Grace” where he has short daily thoughts to reflect on. This particular day the title of the reflection was “A Humbling Experience” and it began with the words:

“Americans come at life expecting everything to work. It always has... People from privileged backgrounds expect that path always to be paved; they expect everything to work out. When it doesn’t, they’re not only disappointed, they feel wronged. They think, “How dare reality not work out for me! Why should I have to suffer? How dare the air conditioner not work?”

Which was exactly what we were feeling. We felt personally wronged and offended by things not working! (No, we don’t have an air conditioner.) We have come back to that reading often as the power outages continue almost daily, to help put things in perspective. We are from a privileged society where things generally work almost all of the time. Here, things are expected to not work most of the time and you just deal with it. For all of their lives the people of Chiltiupán have dealt with not having the things we take for granted such as the utilities. But the list also includes the other basic needs such as education, health care, security etc. We are humbled by the continued positive attitude of the people, the motivation to continue struggling for survival and dignity with great disadvantages that we simply would not tolerate in the US.

Since April we have had a new family living just down the hill from us. They moved to town from down in the valley (about an hour and a half walk form town). The owner of the house we are in and the small store that is next door is visiting relatives in the US. She has arranged for the family to care for the store and the property while she is gone. The family consists of the parents and 10 children, the last two being twin girls about 18 months old. It has been fun to watch them adapt to “city” (actually very small town) life. The kids just stand and stare at vehicles that go by; they especially love the buses. They also get a huge thrill when I back our truck into the garage. I think they line up to see if I will back it over the edge of the hill or not!

It has certainly livened up the activity in front of our door. Often one or two of them are peeking around the corner of our door to see what we’re doing when we’re home. The youngest children are cared for during the day by one of the older girls (about 9 years old) and we often hear her leading them in songs and children’s games. Most of the songs she’s learned from the evangelical church group that meets just down the street from us. She sings with enthusiasm and gets her sisters and brother to do the same!

I don’t think any of them are currently enrolled in school – they moved up from Siberia after the school year had already started and didn’t get their papers transferred. There are also financial barriers to enrolling that many children in school. The public schools are “free” but they children have to have uniforms, shoes, their own school supplies. There are other costs as well – such as paying for pages copied for assignments (books are scarce) and paying a quota for taking tests. The quota is to cover the cost of the testing materials. Like I said above the basic things we take for granted are often available only on a limited basis to the people here.

Peace,
Don

The pictures below show the twins in front of our house, and wires that feed the house and the electric meter hook-up (No problems there!)

TWINS ELECTRIC LINES METER]]> General http://donpat.com/index.php?itemid=67 Thu, 12 Jul 2007 17:37:52 -0400 http://donpat.com/index.php?itemid=66
This past month has been full of a variety of activities and experiences some were highlights of the month and others were not so pleasant, but still definitely a part of the reality here in Chiltiupán. It’s always best to start with the fun experiences!

My sister Beth, who lives in Dallas, Texas, came for a visit the first part of the month. In preparation for the trip, her first to El Salvador, she told us she wanted to have a “Chiltiupán experience”, that she wasn’t coming as a tourist but to see that place she has heard so much about in the past couple of years. I don’t think she went away disappointed. We got to spend time in the clinic, visit the school, walk around the town and visit with people. Since she arrived the weekend of Corpus Christi celebration she also got to participate in the communitywide procession. To round out her experience we took her along on one of the medical “mobile clinics” that we do in the more remote parts of Chiltiupán. This particular “medical brigada” was to Cuervo Arriba which is in the coffee growing region and at a little higher altitude than the town of Chiltiupán. We had hoped to be able to take a 4-wheel vehicle into the area but several days of rain made the road impassable except by foot. So there we were both clinic staff and people from the area, carrying all the medicines and equipment into the settlement. It took us almost an hour to get there but didn’t lack for patients once we were set up. As usual the community leaders who do the ground work for these “medical brigadas” had things well organized and we were able to see a number of patients who would not have been able to get into the clinic due to the weather conditions. Fortunately the rains had let up by the time we were ready to leave and our walk out was pleasant. I think Beth went home having had the full “Chiltiupán experience”. I really appreciated being able to share with her some of what we do down here.

The following week we had a quick visit from another friend in the States, Sr. Anne Marie Gardner, who founded Salvadoran Enterprises for Women (SEW) which helps to promote small businesses set up and run by women down here. Most of the enterprises are formed around a cooperative arrangement and deal with different types of artisan products. At present there is no such group in Chiltiupán, but who knows what the future holds if the conditions are right. It was good to visit with Sr. Anne Marie, find out more about her work and share a little of Chiltiupán with her also.

As I mentioned at the start, this month has held its downside also. We read in the news “on line” that the debate over immigration is getting heated again. It’s a complex problem and no one seems to know what to do with all the undocumented immigrants who are already in the US but all agree something needs to be done. Down here we see the situation from the other side – in spite of all the tough measures that the Border Patrol is taking, in spite of the increased difficulty and danger in trying to cross the border without a valid visa, people are still leaving here in large numbers – and on a daily basis. Most of it is being driven by a situation of extreme poverty and no opportunity for jobs that provide a living wage, or even a substandard wage. The result is broken families – children being raised without their fathers around, and sometimes with neither parent. This in itself generates a whole host of problems. It’s one thing to read the statistics and cases in the paper but the reality of the situation here was brought home to us two weeks ago. José is a very active member of his community and leader in the church. He was instrumental in helping us get the soy program started in his community. He and his wife have an especially strong relationship and he has always been involved in the care and activities of his children. José has a wonderful sense of humor and always ready to help others, and I don’t know anyone who has worked harder to make his little farm produce enough to feed the family. However, the past two years have seen poor yields for the corn and beans and even the innovative crops José and his family tried had problems. His papaya crop was almost destroyed by a late season wind storm this past season. I think he managed to earn enough to cover the cost of what he had invested, nothing left over for the basic needs of the family. Two weeks ago, Father’s Day weekend, he told us that he was “going North”. He has a brother in the States who has been trying to persuade him to make the trip and for several years José had resisted, not wanting to leave his family, wanting to make it work here. I think it’s a measure of his desperation that he finally made the decision to leave. I can’t describe how sad this situation has made all of us. His wife and children are trying to pick up the slack, fill in for his absence, making little jokes with each other and us to try to take the edge off the depression, but the sadness is always there. I don’t know what the outcome will be; he most likely will not be able to cross the border without getting caught. We all pray that he won’t fall victim to any of the many perils that accompany those going “North” without their papers. Keep this family in your prayers and pray that our leaders both in the States and in this country truly start to address some of the underlying causes that create the need for people like José to immigrate. (Click on the following link to see a Washington Post story from June 27th. It is an article on immigration and Honduras, but the same can be written about El Salvador. http://www.washingtonpost.com/wp-dyn/content/article/2007/06/26/AR2007062602131.html
?hpid=moreheadlines)

Peace,
Pat

The pictures below show Jose (closest to camera carrying canopy) in the Corpus Cristi Procession, Beth and Pat, line waiting to be seen at “brigada”, Pat and patient at “brigada”.
José carrying canopy in Corpus Cristi Procession Pat and Beth Watiing Line for consultation Pat and patient]]> General http://donpat.com/index.php?itemid=66 Tue, 26 Jun 2007 22:42:40 -0400 http://donpat.com/index.php?itemid=65
This past Thursday was my birthday (#64) and the high school teachers arranged to take me into The Port (a 45 minute drive) for dinner after their long work day (they start at 7:15 AM and end at 5:30 PM). Even all 5 of the nuns went. The oldest of the nuns, Hermana Lucia never goes to social events even when they are held at school. They said she had not done anything like this for over 7 years! Father Rob, Sister Rose, Pat and the school secretary, Gladys also went. A good time was had by all. They told me that they also had arranged for a marimba band to come to the house in the early morning to serenade me with “maòanitas”, a traditional birthday song, but the band had partied too much the night before and couldn’t get up. I was thankful for not being awakened at 4:30 in the morning!

We are presently in the “transitional” period of the weather. We have had 3 thunderstorms recently but nothing regular. They are now saying the rainy season will begin in two weeks. It is hot and humid all day but still cools at night. The farmers are all waiting for a good rain to help prepare the soil to get the seeds in the ground. They have burnt off all of the remains from last year and cut the weeds. Burning is done all during the month of May instead of plowing. They don’t plow because they have no equipment and they are often farming on steep hillsides. The ground is all prepared by hand. Most of the subsistence farmers are borrowing money to buy seeds and fertilizer that will be paid back if and when they get a good harvest. If they don’t get a good harvest they will be further in debt. Also most do not own their land; they rent the land which is another cash expense for cash strapped farmers. It is a very backbreaking existence and the cycle of debt seems to never be broken. There are some glimmers of hope to address these issues. For instance the diocese Catholic Charities office received a grant to begin a home garden and poultry program to improve nutrition and give a small income source to rural families. They are training will empower women to help generate a small income and food for their family. It’s not a huge program but it is a beginning. These are the kinds of things that can change the outlook for the poorest families.

Peace,
Don

The pictures below show a 5th grade class making waves and bouncing balls on the parachute, three of the sisters (Hermana Lucia standing) at the party, and a typical farm scene near Chiltiupan.
null ]]> General http://donpat.com/index.php?itemid=65 Sat, 26 May 2007 10:30:01 -0400