by Tim Fallis
Today we left the hotel half an hour earlier than usual to avoid the incredibly congested streets of San Salvador that held us up on our first two clinic days. Let’s just say that morning rush hour here is quite an adventure. Once on the highway we drove through pastoral farmlands with striking volcanoes in the distance. After a while, we took the Tepecoyo exit and drove straight up into the mountains. On the way up the views were spectacular – such a beautiful country, so green and lush.
Apart from our regular return to San Salvador’s massive inner city slum called The First of December, we rarely revisit the same clinic site twice. There’s just so much need across the country. But today was an exception as we came back to Tepecoyo, just under a year since we were last there. We barely scratched the surface on our last trip – lots of people who still need medical/dental care. This site is very well suited to a clinic like ours with a building layout that optimizes traffic flow while giving us perfectly-positioned waiting areas too. With 1,100 people patiently waiting when we arrived, we got to work immediately.
Dr. Elizabeth Russell, a Speroway veteran of several Central America trips, was working away assessing and treating patient after patient. At one, very fortuitous moment, she looked up and saw a 30 year old women named Maria who was clearly suffering from a serious thyroid disorder called Graves Syndrome. She brought her over and listened to her story. Among other things, 
she complained of a sore throat. Elizabeth also noticed tell-tale bulging of the eyes. The Graves Syndrome diagnosis, fairly straightforward in Canada, had been missed to date here in El Salvador – but we changed all that.
she complained of a sore throat. Elizabeth also noticed tell-tale bulging of the eyes. The Graves Syndrome diagnosis, fairly straightforward in Canada, had been missed to date here in El Salvador – but we changed all that.Elizabeth quickly connected her with Dr. Sandra Contreras, one of the local doctors who regularly works with us. Between Elizabeth and Sandra, the appropriate meds were prescribed and a long term plan to maintain the required supply under medical supervision was confirmed. Sometimes we wonder just how much good we can possibly do here during our one-day clinics. After all, any meds and other treatment we provide are typically finished within a couple months – at which point life for these people likely goes back to the “normal” they’ve always known. But not today. Elizabeth not only made the diagnosis, she secured longterm treatment so her patient can enjoy better health long after we’re gone. That’s a prime example of the difference we can make.
Later in the morning, Dr. Channy Muhn, one of Canada’s most accomplished dermatologists, called me in to meet 50 year old Margarita, one of Lead Medic Dr. Tony Brown’s patients. Tony referred her to Channy with a sclerotic basal cell carcinoma lesion just under her left eye. It looked innocent enough but it’s far more incidious 
beneath the skin and required surgery to remove it. It was a challenging location – close to the eye, the nose and a major artery. Channy would have to be careful to avoid undue pulling on the eye or even deforming her nose. So within 15 minutes, right there in the back of a classroom in Tepecoyo, El Salvador, a world class dermatologist, brilliantly performed intricate facial surgery. It was a complete success leaving a hairline scar that should disappear completely. Amazing.Dr. Steve Russell, one of our other Speroway veterans, met a 69 year old man name Eleuterio Escobar. Steve diagnosed his marked limp as a severely arthritic knee. This wasn’t surprising after a lifetime of working in the fields of El Salvador. Steve administered a potent steroid injection, directly into the knee joint which should provide several months of relief.
While we live for these successes, we also have our share of tragic stories for which there can be no happy ending. Within minutes of removing Margarita’s skin cancer lesion, Channy met a 74 year old man with odd dark patches on the bottom of his foot. He had gone to the hospital months ago, but they had told him it was simple bruising and not to worry about it. But Channy immediately recognized it as advanced Melanoma – skin cancer is his specialty. Upon further investigation, it was clear that the disease had progressed and become systemic with no hope of effective treatment. In Canada, through surgery, chemotherapy and biologic agents, this patient might have had a chance. But here in El Salvador, those treatments just aren’t available. Unfortunately, this man may not live more than six months. As you might imagine, Channy gravitated to the next young, vibrant child that arrived at the clinic – always therapeutic.
So it was a day that provided opportunities to make a huge difference in the lives of some, along with too many sobering reminders of why we’re needed here in the first place. In Medical, a record 1,014 people were seen and treated. Dental’s count was 232, also an all-time high! And our stalwart Optical Lead, Marie-Andrée Meloche, provided 167 pairs of reading glasses. She’s a one-person team who quietly works away improving the vision of hundreds of people in need. You’re an unsung hero, Marie-Andrée – we couldn’t do it without you.
Tomorrow, we’ll take the day to recharge after three demanding clinics in a row. But we’re back at it on Friday in the village of Zaragoza before returning to the community known as December the First, in downtown San Salvador on Saturday. Tomorrow night, I’ll post a collection of photos covering the first three clinics. They should give you a sense for the people we met and the work we’ve been doing. On behalf of the entire team, I want to thank you for following along – it means a great deal to us all! P.S. Here are a few more shots from today’s record-breaking clinic in Tepecoyo!
