The scenic village of El Zapote, located on the western strip of the pacific coast in El Salvador, is only a short trip to the Guatemalan boarder. There is only one dirt road that eventually leads to Cara Sucia, the next bigger town. The drive takes about 25min for 16km.
The national and private hospitals reside in densely populated areas. El Salvador’s rural health care service is provided by so called "Unidades de Salud". These health care centers are comparable to general practices. They differ in size, staff and equipment throughout the country. In El Zapote there is only one Physician plus a yearly rotating medical student in the 8th and final year of medical studies. Additionally one nurse, a secretary and two so called "Promotores" form the medical health care team. "Promotores" do not necessarily have a medical education, nevertheless they are a huge help by giving lectures, assisting in vaccinations or inducing labor. The catchment area of El Zapote includes about 1500 people. The average daily attendance ranges between 15 to 25 patients. The next larger "Unidad de Salud" is in Cara Sucia. This practice runs 24/7 and holds an ambulance that can be used for transfers to the hospital in Sonsonate. In Cara Sucia a total of three laboratories are available but none in El Zapote.
The majority of the population depends on public health care services. Only about 30% of the inhabitants in El Zapote have sufficient financial resources to seek help from specialists in hospitals in urbanized areas. There is a strong correlation between unemployment and health status. Only about 40% have a permanent employment, whereas most of the population in El Zapote works in farm labor. Thus many Patients cannot afford the travel expenses to seek help in more advanced health care centers. All in all public transportation to and from El Zapote is rather limited with two daily buses at 6:30am and 5:30pm. There are only about 20 Pick-up trucks in private domain.
Most of the adolescents in El Zapote leave after graduating from High School in search of work and better economical opportunities. Birth rate still remains fairliy high, thus many children reside in El Zapote.
Whereas medical consultation including treatment is free of charge in El Zapote, the Unidad de Salud lacks medical equipment and medication. Essential medicines like Amlodipine, Simvastatin, or Amoxicillin and Diclofenac are not always available. Moreover medical equipment like Electrocardiogram is not available in all rural "Unidades de Salud" and even in many urban "Unidades de Salud".