Fall is here and are counting down the days for our return to El
Salvador and back to our sailboat, Knee Deep. We have tentative plans to be in Costa Rica for Thanksgiving, Panama for Christmas and through the Panama Canal in January. 'Tentative' being the key word....a cruiser's life is always flexible!
As promised here is a look
back at another experience while in El Salvador…
Flashback #2 – Living in El Salvador; A Trip to
the Medical Clinic
I’ll be honest, I really liked going to the
doctor up until I was about 9 years old.
It was all about the cool toys in the waiting room, my mom reading aloud
Mrs. Piggle Wiggle books while I lay in her lap and the vanilla milkshake I
received afterwards. But following my
emergency appendectomy, it never really was the same. Doctors were now people associated with
hospitals, operations and I.V.’s.
This worked out just fine considering my father’s
philosophy on medical attention. You only needed to go if limbs were hanging
precariously from your body or there was a loss of consciousness. Considering we were a family of eight and he
worked two jobs, it was not a plausible option to cart six children back and
forth to the doctor. I have memories of coming home with contorted fingers and bloody
cuts on my legs only to be shuffled into the bathroom where the triage would
begin. As a result I grew up believing duct tape, rubber bands and popsicle
sticks were the standard in first aid.
My favorite memory is when I came home from a
soccer game with two particularly bloody wide open gashes on my shin (I wasn’t
wearing shin guards because…well, shin guards were for pansies…have I mentioned
I have three older brothers?). My dad took one look at me and said, “I think
we’ll need to go see Mich for this one.”
At his point you are assuming Mich Michelin is
the doctor who resides in the neighborhood and you would be absolutely……...wrong!
He was actually the Italian father of three down the street and a sheet metal
worker by trade, however, he was the Boy Scout troop leader and he must know something
about deep cuts bleeding profusely, right? So I hobbled towards his house and anticipated
the expert medical care I was about to receive.
Fortunately, Mich didn’t have other patients that
day and I was seen right away. After some head scratching and mumbling, it was
decided the course of treatment would be a butterfly bandage. Needless to say,
I still have two deep scars prominently displayed on my right shin, but I did
not bleed to death and my soccer career continued without a hitch. This is what
the youngest of six children can only hope for, so you don’t put up a stink
about seeing a “real” doctor instead of Mich Michelin.
So as my ear began to hurt during our stay in El
Salvador, I dismissed it as a minor issue and assumed it would clear up on its
own. After several days, I had a throbbing ache in my right ear, lost my
ability to hear and had trouble walking a straight line. Ben frivolously suggested seeing a doctor. It
did not take long to convince me this was a good idea and once the decision was
made, I instantly turned into a babbling nine year old, asking him if he would
take me so I didn’t have to go by myself. I did not, however, insist he read me
a Mrs. Piggle Wiggle book.
After dropping our kids off at our friend’s boat,
off we went at 7:30 in the morning to catch a bus to the “Clinicia de Zapote”, which
apparently was just down the road. As we left the marina, we found a taxi
sitting at the entrance. He assured us he knew where it was, yet stopped to
holler at the security guard asking him in Spanish, “Where is the clinic?”
After driving past it a few times, we reached our
destination which concluded with us flying down the two lane highway for a ½
mile in REVERSE. Apparently there were too many cows in the road to do a U-turn
so this was the only practical option.
We thanked the transportation Gods once again for our safe arrival (not
a foregone conclusion when traveling on buses or cabs in El Salvador).
We entered a fenced in yard with a beautiful
garden and walked towards a cinderblock and concrete structure. Approaching the
entrance, we were met with the friendly, “Buena” and a genuine smile, which is
the norm here in El Salvador. People were quietly waiting in plastic chairs bolted
to the ground in the open air clinic. Over
and over again in El Salvador, I observed that people have infinite patience
about waiting, whether for the next bus or necessary medical care. Maybe it’s that they take nothing for granted
as they are a country in a lingering hangover of a civil war. After watching your family and friends being
dragged away or killed in battle, waiting in line for groceries or for the
doctor just isn’t a big deal. This is
only a personal conclusion I’ve come to, perhaps as a culture they were this
way before. I can’t be sure since I have never stepped foot in El Salvador
until now. Living here has provided me with insights about my own
feelings of entitlement and how to be more appreciative of my life.
So the two gringos walked through the door (sounds
like the beginning of bad joke) and were met with collective stares which we
have grown used to. We engaged in conversation with the clerical staff, which
after a game of half English, half Spanish coupled with charades, informed us the
doctor was not in today. He would be back tomorrow at 7:00 a.m. To be clear I
inquired again, “Sabado? Siete en la manana?” (Saturday? At 7 in the morning?).
A smile and nod confirmed that this was the case.
After reading the hand painted signs on the walls, I deducted that most people
were seeking dental attention on this Friday.
Baffled that a medical doctor would be holding examinations at 7 in the
morning on a Saturday, we hopped on the bus back to the marina.
I awoke bright and early the next morning and
hopped back on the bus at 7:00 a.m. By the time I arrived, there were already 20
– 30 people waiting to be seen. I spoke with the same clerical staff that
showed infinite patience with me as I fumbled my way through the paperwork.
Finally, the woman looked at me kindly and took the paper from me since I was
unable to understand most of the questions. The doctor appeared and helped me
fill out some of it, with the whole episode ending with the papers mostly
incomplete. They looked at me, smiled and shrugged their shoulders, saying in
Spanish, “You can go sit in a chair and wait to see the doctor”.
I made my way tentatively to one of the plastic
chairs and took in my surroundings. Not a boutique office by any means, but it
was clean and I was confident they couldn’t screw up my ear more than it already
was. I noticed the armed guard standing at one of the rear exits, a familiar
sight in El Salvador.
Apparently after the war, this was one way to
employ the many men who had been trained as soldiers (a good part of the male
population). We soon discovered this has continued as an economic strategy, not
because there was danger around every corner. Upon closer observation, we saw most
of the security guards’ weapons are old American automatic guns that are rusted
through and contain no ammunition. I must admit it was intimidating at first. While shopping at the El Salvadorian equivalent
of Costco, it can be unsettling seeing a 30 foot guard tower looming in the
parking lot, with a gun toting man’s silhouette. However, it’s interesting how
quickly we became accustom to this. The security guard at the fabric store actually
helped me carry my bags to the van.
So as I sat in the waiting room next to a father
holding his feverish daughter, I did not give the armed security guard a second
thought. After 30 minutes I was called over to have my blood pressure and
temperature taken. There was no fancy
forehead scanning thermometer, just a simple mercury stick I knew as a child
and was told in Spanish to put in under my tongue. I chuckled as I waited and
waited for the nurse to return, until I remembered that these things took a
long time to work. After all my vitals were taken and documented, I returned to
my seat.
Soon afterwards, I was called into the
examination room which was clean, but sparse. No magazines, televisions or
fancy whiteboards for kids to draw on while waiting for their turn, just a
chair, a desk and an examination table. The doctor, who was about 30 years old, smiled
and the conversation/charades began. Communication was further hindered by my
inability to hear out of my left ear. Fortunately,
I came equipped with my Spanish dictionary and a list of medical terms given to
me by our friend Ann. I passed the time
during the bus trips and in the waiting room, practicing what I would say and
surprisingly it translated well enough. Upon further conversation, I learned
that the doctor did speak some English, but was embarrassed about speaking
it. I completely understood this, having
spent the last six months bumbling my way through the Spanish language.
As he reached for the lighted ear examination
thingy (sorry don’t know the technical term), he signaled for me to come closer
since it was hard wired into the wall.
He started to place it in my ear, when suddenly he pulled it back and
started banging it into his palm to get the light working. In broken English,
he said almost apologetically “sometime it work, sometime not so good.”
We both chuckled and shrugged as he gave it
another try. This time he was successful
and confidently diagnosed me with an outer ear infection. I was then told to return
to the waiting room. Curious as to what
the next step was, and a bit confused of how this all worked, I sat back in my
plastic chair waiting as he examined more people. After 20 minutes the doctor called
me back in and wrote some notes on a piece of paper, directing me to go to the
pharmacy to get medication. We shook hands and I thanked him profusely. As he was about to call his next patient, I
asked him where the closest pharmacy was.
He smiled….one of those, “oh, poblecita” smiles……..walked me across the
room to a window and pointed to a sign, “Pharmacia”.
This consisted of a plexi glass window with a
hole cut in the middle and a metal folding chair on the other side. Soon one of the clerks came over and asked
for my paper. She opened the door to the room which consisted of concrete walls
and metal shelving with boxes of antibiotics, ibuprofen and other things I
couldn’t quite translate. You see in El
Salvador and Mexico a prescription is not required for antibiotics, high dosage
Ibuprofen, some sleeping pills and pain killers. On a single bus ride, a person can buy a week’s
worth of Cipro and some darn good pain killers along with some pupusas and a
mango on a stick. I’m not exaggerating. Vendors
hop on and off at bustops selling all sorts of products.
This is the only pic we have of a bus vendor. This particular guy was selling fresh cut fruit.
Mickey enjoys his 5 cent watermelon slice. You can just spit the seeds out the window...how cool!
So to be honest, I was not surprised that the
clerk from the office was doling out my antibiotic ear drops and a butt load of
high dosage Ibuprofen. Instead I thought, “Damn, I love this country!” After loading up on my meds, I shuffled over
to the office once again and asked how much I owed. The woman in the office looked at me, quite
baffled by my question and said, “nada”.
Confused I repeated again and showed them my
money. She giggled and said, “No, no, no. Nada.”
I then tried to offer up a contribution of a
measly $10 which she vehemently refused. So here I was in a 3rd
world country, living on a sailboat using their government funded health care
system and there was no monetary compensation they would accept (and probably
thought I was bribing them in some sort of manner). So with a respectful nod to
Miss Manners ….I sat back down in the hard plastic chair and wrote a thank you
note in Spanish. Using my dictionary, I
cobbled together a note expressing my appreciation. It was the only thing I could think to
do.
When the doctor appeared again, I handed over the
simple note feeling like a little school girl.
As I was apologizing for the mistakes, he looked up with a surprised
look in his eye and thanked me.
So I hopped back on the bus and returned to the
marina with my new stash of meds. When I got back, I immediately googled the antibiotics
given to me and this is what I discovered:
“It is considered a prototypical broad-spectrum antibiotic, and as it is
both cheap and easy to manufacture it is frequently an antibiotic of choice in
the Third World…….. Due to resistance and safety concerns, it is no longer a first-line
agent for any infection in developed nations…. Nevertheless, the global problem
of advancing bacterial resistance to newer drugs has led to renewed interest in
its use”
So there you have
it, a good old fashioned, no frills antibiotic and my experience with a third
world government funded health care was a positive one. From the other cruisers I have talked to,
this has been the typical encounter. Within
two days my ear was on the mend and I had regained the ability to hear all the
frat brothers on the Floating Frat House.
Then again, maybe I should have held out a few more days!
Cheers,
Molly
The guard tower at the El Salvadorian Costco
Surpsingly the bus vendors don't sell these.....only in the store. Fifth roommate on the Floating Frat House?? I think NOT!!!
