The San Salvador clinic is the largest of the three and operates like a private hospital, seeing 400 to 500 patients for consultations each week. FUDEM was started roughly a decade ago by a few business women and has not stopped growing since. The acronym stands for FUNDACION DE MUJERES (Women’s Foundation). The clinic has six full time optometrists and six ophthalmologists examining patients on any given day. They have their own surgical theatre for cataract & minor operations. (A phaco machine is near the top of their ‘things to buy next’ list.) Astonishingly, entry to the clinic is US$7. The one time charge covers the initial optometry appointment, any necessary ophthalmology appointments, and any subsequent surgery (where the patient can not afford to make a contribution to its cost). Clients are charged for the frames and lenses they require. But because FUDEM have their own optical lab in which to produce the many prescriptions they fill each week, the glasses are available at heavily discounted rates, and, as with all the services they provide, the charges can be reduced or disregarded according to the patient's ability to pay.
Obviously FUDEM are not making any profit from the services they provide, nor are they even close to breaking even. As they receive no financial support from the national government, they are entirely dependent on the generous support of a number of international charitable organisations (including Desert, Christian Blind Missions, and VOSH California).
FUDEM also has an outreach team that travels to all corners of the country, working six and sometimes seven days a week in order to service the most distal regions. I joined the team on the day that they were visiting the village named Jayaque. They are well organised (as you would expect from a team that basically works everyday of the year) and normally wouldn’t have needed the help of someone like myself. However, the day I joined them, two of their usual team members absent.
I attempted to make myself useful at the beginning of the day by measuring visions at the second o six stations. I was untroubled by the patients with 20/20 vision bilaterally. I was hopeless when the patients required instructing due to my one word approach to ‘speaking’ Spanish.
Later in the morning, I moved to the refraction station, where I was encouraged to do some work so that they could take some photos. What followed was an awkward examination on account of, my abovementioned Spanish skills, the fact that I had displaced the regular optometrist who was now standing and watching, and the flash-flash-flash of the enthusiastic photographer (who admittedly got some great footage of me in action, which I am still hoping to receive by email). Following the photo shoot, I set up a second refracting station beside the primary optometrist and picked out the patients who only required a correction for near work. In this way I was able to help with the patient load.
During one of the slower moments in the refracting room (which had its own portable phoropter set up) the Spanish optometrist asked me how many patients I would normally see in a day of practice back in New Zealand (at least that’s what I thought he asked). Naturally I exaggerated (as you do in these situations of professional competitiveness) choosing to base my response on a busy day of short cases, ‘twenty’ was my reply. I asked the obvious next question, “y Tu?” ( “and you?”, one of the few Spanish phrases I am confident with), to which he responded ‘two hundred’. His answer promptly ended the conversation via an awkward silence. We saw about 130 patients together in the half day that we were in operation.
The success of FUDEM within El Salvador is one of the reasons that there is no Cuban eye team in the country. Apparently there is a political dimension to their non-presence also, given the recent election of the leftist party to power (this party was formed from the ‘guerrillas’ of the 1980s’) there may well be agreements for a Cuban initiative in the future. The work FUDEM does is large scale and their level or organisation is impressive, as it has to be to achieve what they are achieving. They are an outstanding example of what can be achieved in areas such as Central America and I am really glad that my last opportunity to volunteer this year was with them.
Concluding Remarks
And so ends my year of travelling and volunteering. From here I return to Australia to reconnect with my family & country, and to carefully consider the options I have before me concerning my professional future. Somewhere in the first half of 2010, when all the information is in, I will decide on a direction for the next few years of life. I will be choosing between the opportunities that have arisen from my travels this year, alongside those that present themselves back in Australia. If you are of the praying kind, please remember me while on your knees as I ponder where to best position myself so as to be of most assistance to people in need.
Thanks for taking in interest in my movements this year, I was greatly encouraged by the correspondence I received after each post. In fact, it was after receiving replies to my first report that I realised that, in a sense, I wasn’t travelling to the places I was visiting alone, I was taking all my friends and colleagues (‘my contacts’) with me.
Thanks and thanks again.
Peace be with you ...
lucas
