We conducted our final clinic in what we had always known as Somalia.  It’s a massive tract of land in the middle of San Salvador and home to the largest, most deplorable slum in the country.  The conditions are unspeakable – cardboard, plastic or tin homes, dirt floors, open cooking fires, fences and walls made from rusty bedsprings and no running water.  A few homes have electricity, but only because it’s been pirated from neighbouring hydro poles.  Gangs, crimes, prostitution and drugs are everywhere.  Needless to say, these families are El Salvador’s poorest of the poor.

Interestingly, upon arrival this morning, we learned that locals no longer refer to this area as Somalia.  Seven years ago, on December 1st the citizens here collectively decided to come together to try to make a go of it on this dusty and inhospitable piece of land – not as individuals but as an organized community.  More recently, the citizens decided to opt for a new community name – The 1st of December – in honour of that important moment.

I was last here nearly three years ago and was eager to return.  It’s a clinic experience unlike any other – we’re outdoors under tents and tarps and the line-ups are long.  I recognized a young mother I met on my first trip.  I pulled up her picture on my iPhone – she thought that was pretty cool.  I doubt she remembered me, but I sure remembered her.  There were lots of inspiring stories today – far too many to recount – but here are just two.

Ross Taylor, a Speroway veteran and Durham region paramedic, met Marcos, a 34 year old iron worker.  It’s a real challenge for many 1st of December citizens to find steady employment – Marcos was one of the lucky ones.  Unfortunately, his luck ran out – an on-the-job accident changed everything last June.  He showed Ross major wounds at the bottom of both heels.

Through three surgeries, three toes had been amputated, two on the right foot and one on the left.  Then Marcos told his story.  It seems while handling an iron rod it contacted a live power line and he was electrocuted.  The current exited through the bottoms of his feet but did tremendous damage along the way. Electrical exit wounds are usually severe and take months or years to heal – and often don’t.  The wounds on Marcos’ feet weren’t doing well.  Ross redressed them, provided antibiotic ointment and, more importantly, educated him on how to repeat the process in the future.  Needless to say, Marcos is not working and can barely walk with the aid of a cane.  But Ross made a difference for him today.

RN, Lauren Hubley met 6 year-old Cynthia who was carried in by her mother.  She was incapacitated, unable to use her limbs, had a permanent feeding tube in her nose and clearly suffering from some form of brain damage.  After undergoing heart surgery at 9 months of age, Cynthia recovered and was developing normally.  She was born with a cleft lip and palate and at 1 1/2, she was scheduled to have this congenital abnormality repaired.  Something went wrong during what is generally a routine procedure and she was deprived of oxygen for an extended period.  The brain damage was extensive and she’s destined to be noncommunicative and almost catatonic with miminal response to stimulation for the rest of her life.  There’s very little that we can do for her but in the course of Lauren’s interaction with the mother, she learned that they could never afford a wheelchair.  Her mother has carried her everywhere for the past 3 1/2 years.  Obviously, as she gets older, this will be problematic.  And this is where Speroway really shines.  The team consulted with agency President, Ken Dick and within an hour a truck had travelled to a nearby assistive devices store, bought a $600 wheelchair, returned and presented it to the family.  This will change daily life for Cynthia’s mother – she was overwhelmed and cried when she heard the news.

As our day here drew to a close and we’d started the 90 minute process of tearing down and packing up, we got word that right next door to the Medics station, in a makeshift church, lay a man so gravely ill that he was unable to leave.  Paramedic Ron Sonoda, Nadia, his translator and I did a housecall with an armed guard.  We found him in a hammock, emaciated and clearly near death.  He was brought to the Church to die.  Lauren and Dr. Steve Russell arrived and confirmed Ron’s assessment that there was little we could do for him.  They suspect the mass protruding from his abdomen is end stage cancer of one or more of his vital organs.  This was a sobering end to an incredible day but we took strength in our team’s amazing work here in the 1st of December.  We saw a record 1,004 patients in Medical and 207 in Dental.  Astonishing results in a community desperate for our help.

Our work would be impossible without a committed team on the ground here in Central America.  A team that works tirelessly throughout the year planning, organizing, meeting with municipal officials and exploring viable clinic sites.  This team is lead by Efrain de los Rios.  Words can’t express how important Efrain is to Speroway.  When we arrive in El Salvador or Guatemala, he has organized everything – the buses, the hotel, the meals, the police protection, the clinic sites, the container of medicine and supplies shipped down by sea, and the list goes on.  No final blog post would be complete without a tribute to Efrain.  He has the sincere thanks of the entire team.  He’s a mover and a shaker down here and always finds a way to make it happen – whatever “it” may be.  Efrain, we’re in your debt.

So, for all of us, it’s hard to believe our week is over.  We worked incredibly hard and, now that it’s done, we sit here utterly exhausted.  Yet there’s not a soul on this team who wants it to end.  We’d be right back at it next week with the same enthusiasm and commitment if we could.  This work is that special.  It’s hard to explain how a challenging and emotional week like this can turn 30 people into such a close-knit and smooth-running machine.  What fantastic people they are.  And thanks again to you for following along this week – it’s been another amazing experience for me and knowing you were checking in for updates now and then made the late nights worthwhile. Until the next time – and there will be a next time.  For now, stay tuned for news of the next Speroway Medical/Dental Clinic trip.  So long from El Salvador!  Finally, here are some more shots from today in the 1st of December.