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Vision Quest

S.B.’s Direct Relief International Brings Sight to
Salvadorans

by Sherry Villanueva

Fifty-five cents was all Rosalina needed. Fifty-five cents
for the bus so she could take her son to San Salvador, where a
doctor might be able to help him. The boy was eight years old, with
severely impaired motor and mental skills. He had not learned to
walk until he was four, and he had never spoken a word. He was a
burden for Rosalina, who loved her little boy but had five other
children to care for. She had no access to medical assistance in
her small village 60 miles northwest of San Salvador. She had no
real idea what was wrong with her son. Rosalina was very poor, she
supported her children on her own, and 55 cents represented a day’s
worth of food for her family.

el_sal_photos_167.jpgWhen FUDEM (Fundación para el Desarrollo
de la Mujer) set up a mobile eye clinic in Rosalina’s town, she
brought the boy there with the hope of finding a doctor who could
“give him medicine to make him better.” What Rosalina did not
understand was that her son had been born with cerebral palsy, an
incurable condition. When Rosalina came to the clinic, she was met
by a team of norteamericanos, and I was one of them.

We were 10 women from Santa Barbara, united in our desire to
make the world a little better, but distinctly different in our
backgrounds and the talents we had to offer. Medical professionals
to political activists, we had come to El Salvador as part of Women
for Direct Relief, a support organization that raises money and
awareness for Direct Relief International (DRI), a medical aid
nonprofit that donates medicine and medical supplies to the nations
with the greatest need. As a boardmember for DRI, I cherish the
opportunities to see its impact around the world firsthand.

We joined FUDEM’s visual health campaign roving through the
countryside of El Salvador, bringing its people a better quality of
life through sight. Clinics are set up for one day in schools or
other community centers offering free visual acuity screening,
prescription eyeglasses, and surgical referrals. Vitamin A
deficiency is the most common cause of preventable blindness in
children worldwide. According to a USAID-funded survey, one out of
every three Salvadoran children less than five years old is vitamin
A deficient. In contrast, the condition is extremely rare in the
U.S. With this in mind, FUDEM clinics now distribute high-dose
vitamin A supplied by Direct Relief and Leiner Health Products to
all children.

FUDEM is the brainchild of Executive Director Nina Paloma.
Paloma is a passionate and vibrant woman with deep brown fiery eyes
and boundless energy. Fifteen years prior, Paloma and some of her
more privileged women friends struggled to comprehend the massive
disparity of health and opportunity in their country.

El Salvador is home to some of the world’s poorest people, with
nearly 50 percent living below the poverty line. The average family
income in the rural areas is less than $1,200 per year. Diets are
poor, and many people have no access to health services
whatsoever.

Researching how they could have the greatest impact, Paloma and
her friends discovered that more than 65 percent of the adult
population in the urban areas of El Salvador was without access to
vision care, while more than 85 percent of those in rural areas had
none. Poor vision has devastating effect on productivity and
standard of living. Adults cannot work to provide for their
families; children cannot perform well in school or sports; and
seniors who can’t contribute to the family are often cast off and
forgotten.

el_sal_photos_322.jpgPaloma is revered by her staff and by
the community she serves. She has an inalienable commitment to
deliver only the highest quality of service to her patients,
despite their limited ability to pay. As a result, the FUDEM clinic
is a sparkling, modern place, with a level of quality found in eye
clinics in the United States.

FUDEM provides vision care services to anyone in need, and
patients are asked to pay what they can afford, which, for many, is
nothing. Seventy-five percent of patients pay less than $3 for
services. Those who can pay more generally do, and this retail
business subsidizes the free service. FUDEM has six
ophthalmologists and 12 optometrists in the San Salvador clinic and
serves an average of 350 patients per day with full optometric and
surgical services.

After a brief training in the capital, my colleagues and I
struck out by minibus and boat to three tiny rural communities
(Izalco, Isla Tasajera, and Candelaria) during three days, each
town about two hours from the city. The towns in general were
extremely poor. They were orderly and clean, but houses were of
simple wood construction, often with dirt floors and branches or
corrugated tin for roofing, with no plumbing or electricity.

Despite the pervasive poverty, the people we met were warm and
friendly. School children wore clean, mended uniforms; women were
in their finest skirts and aprons with rows of cheerful ruffles;
and men wore clean, starched shirts. The intergenerational
connection and strength of the family system were apparent
everywhere.

In each village, hundreds of people waited patiently for our
services. Many had walked long distances or paddled by canoe for
hours to reach our clinic. Knowing we were coming, they greeted us
with marching bands and dancers. Town officials assembled to make
speeches and salute us with great fanfare. Children smiled and
waved as if we were visiting dignitaries. I was humbled and
embarrassed by the abundant gratitude showered on us.

In the visual acuity exams, we were shocked to see how many
could not see even the large “E” at the top of the chart. Three out
of five people screened were not able to read past the third line.
Many were illiterate, in which case we would resort to a symbol
chart instead. Most had never had a visual exam before. In all, we
were able to screen and treat 1,800 patients and we felt proud of
the difference we had collectively made.

We met Rosalina and her son, who came to us in the hopes of
finding a cure. But we were an eye clinic and although we couldn’t
treat him, we gave Rosalina the 55 cents she needed for bus fare to
take him to the city. When we said goodbye to her, she wept in
gratitude because someone had listened to her story, had told her
they care. I realized then that more than just vision health,
FUDEM — working in these remote communities week after
week  — delivers hope.

For me, a chance to spend a week with nine strong and
compassionate women in the villages of El Salvador was the best
girls’ getaway I could ever imagine.

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