Delegation visits community health team, sees what's at stake in March election

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While Joe Biden was visiting Central America to push the old, failed solutions of militarization and neoliberalism that serve the international 1%, the CISPES delegation witnessed a new road being built by the FMLN.  One of the centerpieces of the FMLN’s work to expand access to health care are the Equipos Comunitarios de Salud Familiar, community health teams known simply as ECOS.  Funded by the Ministry of Health, ECOS provide free health care to families in rural areas. Since the FMLN presidential victory in 2009, over 400 ECOS have been formed, serving the poorest 140 municipalities in El Salvador. To visit the ECOS that serves the caserio of San Francisco Dos Cerros, we began at the health center in the town of El Paisnal, about an hour outside of San Salvador then traveled 45 minutes by bus up a bumpy dirt road, passing uncultivated lands and abandoned houses, to San Francisco Dos Cerros, where we met with the ECOS health team. The ECOS are comprised of one doctor, one nurse, a health promoter, and a jack-of-all-trades staffer who supports the needs of the ECOS, such as driving or attending to repairs around the health clinic.  With modest resources, the ECOS we visited provides basic preventative care to over 2,100 residents and 530 families in three casarios. The doctor and the nurse accept patients at the ECOS clinic three days a week and travel to visit patients on other days. Meanwhile, the health promoter makes home visits to provide prenatal care to pregnant women, to make sure that children in the community are up to date with vaccinations and in general good health, and, very importantly, to develop relationships with families. Francisco, the health promoter we spent the morning with, stressed that one of his main roles was to create trust between the ECOS and the families in order to deliver quality care, particularly to be able to address issues of sexual health with the adolescents, since such topics are still taboo in El Salvador. We accompanied Francisco on a visit to a pregnant patient, a mother of 7 who was visibly very happy with the care she was receiving from the ECOS.  She shared with us, that the community had always wanted a health clinic because “It cost so much to get to El Paisnal to give birth.  I was always so worried, but now I’m not worried.” Delivering healthcare door-to-door is a trademark of the Cuban healthcare system, as is a focus on preventative community care.  Thus, we were not surprised when Tania, the young doctor who coordinates the ECOS, told us that she had studied medicine in Cuba. She explained that under Salvadoran law, the patients do not pay for public health services and that in fact, it is illegal for the ECOS workers to accept any cash or in-kind payment from patients. The ECOS are a manifestation of the FMLN’s commitment to meeting the basic human rights of the Salvadoran people.  As the 2012 CISPES elections observation meets with allies here in El Salvador, one of the main questions seems to be whether the reforms instituted by the FMLN government thus far have consolidated enough popular support to counteract the combined power of the right-wing, the media, the Salvadoran elite, the US and multinational capital. With the slogan Con tu apoyo, el cambio sigue (“With your support, the change continues”), the FMLN is asking the Salvadoran people to trust them to continue the social transformation. The future of programs like the ECOS, along with other new social investment programs like the free uniforms for all school children, which has generated over 40,000 jobs and helped increased the number of kids in Kindergarten by 13,5000 in the first two years, hangs in the balance with Sunday’s elections. If the right-wing parties (ARENA, GANA, and others) increase their seats in the Legislative Assembly, they will likely move to cut the budgets for these programs, which they have already called “unnecessary” and “wasteful.” In the bigger picture, Sunday’s election will determine whether the FMLN wins the political power they need to stand up to neoliberalism and to continue on the new road toward revolutionary change. The Ministry of Health has called on international allies to support the ECOS and other new programs to ensure health care for all in El Salvador. To read more about CISPES' upcoming medical brigade this August 2012, please click here or contact [email protected] for more information.

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