Rebuilding communities together in El Salvador

Everyday existence is a struggle for the 550 inhabitants of El Milagro in Platanillos — a small canton located near the city of Quezaltepeque, El Salvador.  Most of the people who live there are unemployed and scratching out a meagre subsistence existence.
In reality, the community El Milagro didn’t even exist until 2005, when the entire community was relocated by the previous government after a terrible earthquake in 2001.  After the earthquake, the community was relocated to a site near a garbage dump, before ending up in their current location.  The government of the day promised to move the community to a better location and provide housing, land titles, infrastructure, and services – including solar panels for electricity.  The first wave of inhabitants were moved and provided with the most basic of housing, but another 120 families got nothing, and no local infrastructure, land titles or services were ever provided.

Like many rural communities in El Salvador – a long history of previous government neglect and exclusion has resulted in high unemployment, high rates of illiteracy, low matriculation rates and the associated social ills that accompany this kind of exclusion.  Add to the mix a complete lack of potable water, sanitation, recreation, community organization and access to basic services.
The first-time national election of the Farabundo Marti Front for National Liberation (FMLN) in March 2009 signalled a desire for real change on the part of the majority of Salvadorians.  And, while the FMLN government has begun to implement a number of important changes in the country, real systemic and institutional change resulting from the legacy of a succession of corrupt, right-wing governments has left few resources to combat the serious issues facing the majority of the population. 
Despite the enormous challenges facing the FMLN government, significant changes, particularly in the fields of health and education, are beginning to take place.  For example, in late 2009, the government introduced “Let’s Go to School” – a mandatory public education program that provides all children, regardless of economic status, with the necessary equipment to attend school – a school uniform, shoes, books, pens, pencils, and a daily hot lunch.  As well, the government introduced a volunteer-driven National Literacy Program – with the goal of reducing El Salvador’s 18% illiteracy rate to 4% by 2021.     
Important health reforms were introduced in 2010 – focusing on integrated community-based healthcare and health promotion that involves the population in taking responsibility for their own health.  The program established Community Family Healthcare Teams (ECOs) – where doctors and health specialists are located in communities and are responsible for up to 400 households.  The doctors do not perform their work in clinics, rather, they visit the households (on foot, or by moto) on a daily basis to administer healthcare.  Plantanillos is scheduled to receive their ECO in 2012. 
To provide a bridge to Platanillos before 2012, the canton is receiving direct support from the Vice Presidential Commission for Social Action – an integrated, participatory and community-based project of the office of Vice President Salvador Sanchez Ceren and his life-long partner, Margarita Villalta.  The Commission’s work is meant to complement and support new programs that have been put in place by the FMLN government.  Villalta says that during the first few months after the new government was in place, the Vice President’s office began receiving hundreds of letters from individuals asking for help – everything from employment to legal and medical assistance, housing and education.  Many of the individuals that wrote for help belonged to historically neglected and marginalized communities, where extreme poverty has impacted every aspect of their lives.  Rather than deal with requests for assistance on an individual basis, the office formed a commission to deal with the issues in an integrated manner. 
The basic premise of the Commission’s model is to build inter-institutional cooperation between national, regional and municipal institutions, communities, and non-governmental organizations (NGOs) that have scarce resources to support the community’s own interests and development on their own.  This hasn’t been an easy road – there is no culture of cooperation or integration between the three levels of government, let alone NGOs. 
The Commission’s work is focused in three areas: 
1)    healthcare
2)    education
3)    local economic production 
The three areas of focus function within global goals of environmental sustainability and direct community participation and organization.  The Commission acts as facilitator for a number of agencies and organizations that work together as volunteers on weekends to bring badly needed services to neglected communities. 
The Commission began by identifying a number of communities of varying backgrounds but with the same characteristics – weak support for any kind of economic production whatsoever; lack of nearby access to services like potable water, healthcare, education, garbage collection and adequate housing; neglected infrastructure; high rates of extreme poverty and unemployment; fractured families with a high number of single mothers and youth; and, established grassroots organizations – a key to community mobilization.  Platanillos carries all of these characteristics, except the latter. 
Working with a local Social Development Association (ADESCO), the VP’s Commission meets with the community on a weekly basis, and holds Social Action Days on a rotating basis — to facilitate access to basic services like health and dental care, medicine, nutrition and education; and to support local organization and community development.  The community is responsible for organizing attendance, feeding the medical brigade, organizing entertainment, and assisting with the set-up and cleaning when the day ends. 
On September 24, 2011, I accompanied members of the Commission on an organized Day of Social Action in El Milagro.  Community and Commission volunteers began setting up early under an already scorching sun.  A group of young men from the community set up a small stage, canopies and chairs – all loaned by the Municipality of Quezaltepeque.  Transportation for volunteers was also provided by the municipality, and women in the community prepared an enormous cauldron of beef soup for the volunteers.   Institutional support included the Office of the Vice President of El Salvador, the National Sports Institute (INDES), Institute for Teachers (and their families) Health, Municipality of Quezaltepeque, Institute for Professional Training (INSAFORP), and the Association of Community Projects El Salvador (PROCOMES).     
A number of us helped set up the medical consultation clinics in classrooms at tiny student desks.  A group of 17 medical volunteers arrived around 9 am to set up both the medical consultations and an improvised pharmacy in the church yard.  Among the medical group, were general medicine practitioners, a cardiologist, an internal medicine specialist, psychologist, nutritionist, dentists, physiotherapists, and government officials to provide services that are not readily accessible for community members.  Doctors provide vaccinations and medical exams; and while their prospective patients wait for their number to be called, a number of cultural activities take place on the stage. 
Most of the doctors are El Salvadorians that have graduated from the Latin American School of Medicine (ELAM) in Cuba; but the group also includes volunteers from the Dr. Salvador Allende Medical Brigade.   All medicine is provided for free.  Dr. Rodrigo Quan, medical coordinator for the Commission, and a Nicaraguan doctor trained at ELAM, said that the most common illnesses are related to high blood pressure, diarrhea, diabetes and poor nutrition.  However, on this particular day, one or two more serious cases require immediate attention in a hospital.  They are evacuated by ambulance.
The intent of the Commission is to support real institutional change, and create a culture of cooperation and self-directed community-building – and while this may not address all of the tremendous pressures and challenges facing El Salvador – it’s a good start.   

*Jay Hartling is an independent journalist and consultant based in San Salvador.  For more information, contact


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