"La Doctora": An Interview with Jaimee Arroyo about Health in El Salvador

 

Last month, Jaimee Arroyo spent one week in El Salvador to assess the health needs in the communities we serve. Jaimee is a Family Nurse Practitioner in the States, where she runs a family clinic for our community and surrounding neighbors. She and her husband, Marco, are members of our Latin America team, committed to serving the poor there. This was her second time to El Salvador, but her first opportunity to focus specifically on providing medical care.

For some of the week, she traveled with Clara, a local health promoter employed by the government to care for over 1200 people in her village and those surrounding it. She has been the area’s health promoter for five years, and, as Jaimee says, she is “the best [health] resource the area has right now."

Jaimee walked with Clara to multiple mountain villages in rural El Salvador to help perform check-ups on Clara's patients. They each benefited each other greatly. It was an invaluable time spent working alongside a fellow caregiver, and making a friend.

Jaimee recognizes that people are resources, not buildings, as there are multiple clinics in the area built by foreigners that are now vacant, serving no one. Only two functioning clinics exist in the area, one private clinic, that costs more than most people can afford, and one free government clinic, that is always overcrowded, and many patients who've waited in long lines all day leave without being seen. There is a public hospital in the nearest city for emergencies, but it's too far for many to get to in time. 

Clara is a registered nurse and functions as a doctor for the people she serves. She visits her patients in their homes, whether they're her neighbors, or they live an hour's hike up into the mountains. She gives vaccinations, performs wellness exams and prenatal and postpartum care, provides water tablets to prevent local waterborne diseases, and gives recommendations for her patients to see specialists in the city. Yet, she doesn't receive enough pay to support herself and her 30-year old handicapped daughter, nor does she have good shoes or a backpack to carry her supplies. 

Jaimee is not only a medical professional, she is an educator. Both in the States and in El Salvador, she is consistently training assistants to both help her and understand what she knows. She is also committed to educating her patients on their illnesses and the health concerns they face, in efforts to both treat and prevent disease.

Two of Jaimee’s main objectives on her trip were to establish a friendly medical presence in the communities, and to find a point person in each community who could objectively report sickness to her in her absence. She determined Clara, who was already trained to assess health, to be that person in one community, and trained up a resident, Lorena, to do so in the other. She was able to teach Lorena how to take vital signs, including blood pressure, temperature and pulse, and listen for lung, heart and abdominal sounds. Jaimee was able to leave all of the necessary supplies to do so with Lorena, and provide Clara with the supplies she lacked.

Jaimee taught a health seminar on dehydration and rehydration in one of the communities. Her proficiency in Spanish allowed her to teach in the language of the people. On the first day of her stay in El Salvador, she used a coconut gifted from a neighbor’s tree to rehydrate a visiting intern, and was able to give the rest of the coconuts as prizes during the seminar. The seminar was much appreciated, as they learned the signs and symptoms of dehydration and how to treat it. Additionally, she provided attendees and families with hygiene packets. After that day, the community started calling her “La Doctora,” and came looking for her to see their sick children.

Jaimee was also able to diagnose and treat multiple illnesses. She said, “I did the same things I would do here.” Without any advanced technology, just the tools for taking vital signs, a few simple tests, a couple of instruments, locally-accessible medications, and a lot of knowledge and care, she was able to drain an abscess, treat a fungus and an eye infection, provide education on kidney disease, diagnose a B12 deficiency and anemia, and make diet suggestions to help reduce a stomach ulcer. She was confident in her skills to know how to address everything she came across. This necessitated listening to their whole story, which she has learned from Jesus (Mark 5:25-34).

Jaimee had much to say about the area’s state of health. Generally, access to care is so limited that people just live with what they have, and many illnesses are left undiagnosed. Overall, there is not much order. Animals run rampant, there is a lot of drinking and depression, women and children are without husbands and fathers, it is a violent place for women, jealousy and mistrust plague the community. El Salvador is a society that has lost its strength. As “health is a predictor of how a society is functioning,” it is a broken place.

Jaimee acknowledges that bringing health to the area is a whole team effort requiring a multi-discipline approach. There’s a need for education, how to take care of the land and livestock, clean water, better infrastructure, more teachers, a functional clinic.

Still more than anything, the people need an ethic to follow. They need God’s Word to teach them how to love their neighbors. This will bring sustainable health like no amount of medicine or supplies could ever achieve. Though it will take time to see such, our Latin America team has the faith to give their lives for this cause.