October 2017 Julian Kositzai


Shortly after publishing my last blog, I gave the first 2 talks (one in El Zapote and the other one in El Porvenir) on nutrition. The participants listened closely as I explained to them the importance of healthy food choices. Even though most of the things I touched on - stay away from sugary foods and soda, eat lots of fruits and vegetables, healthy and unhealthy fats - are dietary recommendations beneficial to anyone's health and weren't necessarily news to them, it's always good to be reminded. The participants agreed that all I could do was point them in the right direction, it's them that have to make the change. That week, as promised, I continued with the sexual education program, this time about pregnancy and childbirth. As always and to my surprise, the boys seemed especially interested. That weekend, I stayed in El Zapote because we finally managed to paint the remaining exterior of the clinic.

As I mentioned in my last blog, we'd planned to get it done 2 weeks before, but were rained out. So since we had all the paint and equipment we needed, we decided to do it that saturday (11.11.2017). Don Fermin, Ebert, around 4 young volunteers and me set to work at 7:30 in the morning and painted away until around midday. The day was hot and we were sweating and splotched with paint by the end of it, but it was definitely worth our efforts!

The following week, on Tuesday morning, medical staff from Cara Sucia came down to El Zapote to take blood samples from the participants of the diabeties project.

All 12 of them (2 joined later on) visited the clinic at 7 in the morning on an empty stomach for the exam. While they were waiting I used the opportunity of all of them being together to give the 2nd talk: On possible complications associated with diabetes. I used images of diabetic feet and diabetic retinopathy among others not to scare them, but to make them understand that their disease is no joke. A few of them had their own stories to share of relatives or friends who lost a foot or leg to diabetes.

The next day, I talked to my Sex Ed class about Sexually Transmitted Diseases, this time decided against fotos, for obvious reasons... Still, as always, they behaved and paid attention.

The monday after the end of that week, I returned to El Zapote with a brand new fetal Doppler monitor, sponsored by Unified for Health.


Oh dear, another 2 weeks zoomed past in what felt like the blink of an eye without me sharing my experiences. I just got back from another eventful weekend in San Salvador, energized for another week in El Zapote.

Let's try to get you up to date: The project that Dr Ramires, responsible for all the Health Units in the area, proposed is up and running.  Basically, it's a follow-up to the diabetics group project started almost two years ago. The plan is to organize 4 events with talks on nutrition and lifestyle for a diabetic patients over the course of the next 4 weeks. We invited groups of participants formed in El Zapote y El Porvenir. At the beginning of the project and after the 4 events have been given, the patients' glucosylated hemoglobin will be measured. Additionally, the participants' glucose levels will be taken on each talk.

The aim is to see if our advice and recommendations that we give during the talks have an impact on the participant’s sugar levels. By doing this we want to monitor how effective this sort of group activity is.  We went around El Zapote and El Porvenir inviting people to participate and 5 people each attended the first (informative) talk. Even though, we'd hoped for more, we decided to carry on. The first talks will be this week and I'm eager to see how it all pans out.

So much for the Diabetics group. At school, I gave my second Sex Ed talk, about sexuality and sexual relations. The topic really seems to grip the students, which is why I've decided to keep the presentations coming in the future - In the next one I'll be talking about pregnancy. 2 weeks ago, I gave my first German language class to those interested students, who sacrificed their
free time to come to class. The second lesson followed on Wednesday last week and the kids really seem to enjoy learning about a different culture and language thousands of miles away.
Obviously, one lesson a week for 4 weeks is too little time to see real progress, but perhaps it's enough to spark interest in foreign languages and to give them the basics necessary for further (self-)study.

In my spare time, I joined in the soccer training sessions, explored the magrove forest in canoe, went fishing and helped decorate graves on Dia de los Difuntos, among other things.  We'd planned to finish painting the Unidad (Health Units)'s exterior last weekend, but due to rainy weather we left it for another time. Let's see if we can get it done this weekend, I'll keep you posted.


As for the first weekend, I decided to stay in El Zapote, preparing the talks for the next week, playing some futbol playa at the beach and going to see a 11 a side soccer tournament right here in EL Zapote.
When I got to the school Tuesday morning for my little talk on hygiene I realized there was an event underway: An earthquake simulation. I gave the students, around 13 years of age, advice and recommendations on personal and public hygiene, demonstrating correct hand washing techniques.

El Salvador has suffered devastating earthquakes in the past, which is why the "simulacro" is a very useful part of the curriculum. I was quickly assigned to the medical squad and "treated" young patients who had been hit by "debris" or suffered other accidents.
Afterwards, teachers and students were evacuated by water to Barra de Santiago.
The next day I spent with Janeth in the office, taking a look at her work and the cases she handles. One especially remarkable patient:
A teenager of 17 years who'd been victim to a beating by other adolescents. The family couldnt afford transportation to the hospital to treat his injuries and the young man didn't feel comfortable talking to authorities about the incident either...

The first meeting with the Diabetics Group went well, too. Don Fermin and I chose to discuss the risks of a diabetic foot and the six or seven people who joined us seemed interested. We ended by offering to carry on with the exercise program - Let's see if we can arrange something. My planned meeting with Dr Ramires didn't happen, unfortunately, because of transportation difficulties, but I'm sure we'll get a chance to sit down and have a talk sooner or later. That weekend I spent back in San Salvador and enjoyed some of the nightlife and also went to the beach "El Tunco" - a known surf hotspot, and climbed the volcano "Izalco", the stunning view making up for a tough ascent.

After changing accomodations, my third week started with another talk at school: The first presentation in a series on Sexual Education.  After everyone was done giggling, the students listened attentively, the boys being especially interested in the process of menstruation, since often parents don't educate their children on these kinds of issues around here.

On Friday, Dr Ramires, responsible for all of the Unidades in the area dropped by and proposed his own little project, to do with the diabetics group. Let's see how that turns out...

First Impressions: 09.10.2017

I left Germany for El Salvador on Saturday, 30.09.2017, and got there around 35 h later at night, via Spain and Panama. Needless to say, I was grateful that Edgar, a friend of Lukas's, picked me up. He took me to his place where I stayed the night and made sure I had everything I needed. The hospitality El Salvador offered me wouldnt end there, but I will get to that later. The next day we headed out early in  the morning to meet Doctora Torres in Sonsonate, more or less halfway between the capital and El Zapote, my home-to-be for the next 2 months. On the ride to El Zapote I admired the bright green colors of the landscape and chatted with Snr Torres about the situation at the Unidad the Salud,  only stopping for my first meal in El Salvador, Pupusas, eaten for breakfast, lunch and supper, according to the doctor. Having arrived at El Zapote, sitting on the coast of the Pacific Ocean, we went looking for a room for me to stay and I ended up staying
at Antonia's, across the street from Sonja's. Since the Health Workers wouldnt arrive until the next day I used the day to rest up and get to know my new home.  I met most of the staff at the Unidad, a few teachers from the local school and Don Santiago, hotelier among other things at Sonja's diner, where I would have 3 meals a day from that day on.

The following day, Tuesday, I met Suleyma and Don Fermin, both health workers (so called "promotores de salud") and accompanied Don Fermin on his daily route. That day we
checked on 3 pregnant women at home, and Don Fermin gave them a talk about the women's and baby's needs. We also checked the water receptacles around the properties for larvae and applied "abate" (little bags of pesticide) where neccessary. After our visits, I came over to Don Fermin's place for a drink and to schedule the first  meeting with the diabetic's help group and ended up chit chatting for at least 2 hours. That same evening the school hosted a small event featuring a soccer tournament for the youngsters and a sort of  stand up comedy show. I was introduced to the school principal and I promised to drop by the next few days to see if we could fix a time
for me to talk to the kids about issues like hygiene or nutrition.

On Wednesday, I headed out with Suleyma, the other health worker, on her motorbike, to make some visits to families in Porvenir, a little distance from El Zapote. Suleyma administered tetanus shots and reminded a mother of a malnourished child of the need to get the child's weight up,
amongst other things. That evening, Don Santiago and me went all the way out to the sea by boat and took a refreshing dip in the water.

I also arranged a time to hold a little talk about hygiene with the school's principal the next morning and had lunch with Don Fermin and his boss and Don Fermin's place.
To sum it up: I was received and treated like family in El Zapote.