Two Salvadorans

 I Care International did something new during its 2024 mission to El Salvador.  We were asked by our hosts to devote our first day of clinic to the residents, staff, and neighbors of a small congregate center for children and adolescents.  We immediately agreed to help.

The name of this small institution is important.  Hogar in Spanish is home, as opposed to casa which is house.  Agape is a Greek word which translates to unconditional love, a wonderful concept but one humans struggle to live up to.  I encountered that word before in my career as a social worker serving children and families.

The staff of Hogar Agape take pains not to identify their facility as an orphanage.  Orphan implies a child whose parents are deceased.  Throughout the world that is rarely the case for children who find themselves being cared for by those outside their family.  Most children in such situations have parents but cannot live with them for a variety of reasons; poverty, abandonment, abuse, and neglect among them.  

A turn off a well-traveled highway outside San Miguel took our bus up a steep and rocky dirt road.  As our bus climbed the hill, we were about to enter El Salvador’s child welfare system.

As we neared the facility, the road ran out.  The last two hundred yards were too steep and rutted for the bus.  Some walked the rocky path to the gate.  I rode in a 4x4 truck with big tires carrying our equipment.  The driver of the truck was a young woman with a great smile who had full control of its manual transmission, downshifting often and at the right times.  She was Hogar Agape’s superintendent.

At the top the path ended, a gate swung open, and we entered the grounds of Hogar Agape.  A sturdy fence surrounded a small group of brightly painted buildings and cottages.  Children of all ages and adult staff greeted us.  I sensed that they didn’t get a lot of visitors, especially those packing 6,000 pairs of used glasses, optical equipment, and several suitcases of donations. We figured if we were coming all that way, we could bring them more than glasses.

Their modest requests prior to the trip gave us an idea of their needs.  In the suitcases were toothpaste and toothbrushes, barrettes and hairbrushes, and various other personal care items.  When we relayed their requests to our I Care members and supporters we were floored by their response.  Many responded with gifts of cash.

They guided us to a small central building where we set up six stations: intake and eye charts outside, nurses, auto refractors, eye docs, and dispensing inside.  Though we anticipated serving only a hundred or so patients, and tried to limit ourselves to equipment and glasses which were absolutely necessary, I think we unpacked just about everything.

We gave eye exams to everyone; children, staff, neighbors, and the vehicle drivers.  Not our normal population.  When free clinics are advertised in needy communities, they attract people who struggle with their vision and have good reasons to seek help. At Hogar Agape we delivered a lot of good news.

“Enhorabuena, tus ojos son buenos.  No se necesitan gafas.”  (Congratulations, your eyes are good.  No glasses needed.)  At the same time, we encountered many whose vision needed correction.  For most, it was their first eye exam ever.

I fit a young woman I thought was a staff member with a serious degree of myopia who had never worn glasses.  She was so delighted when she looked out the window at the trees, she laughed out loud. 

But as much as she liked the new view, she was choosy about the style.  I have long since forgiven people of all ages who desire attractive eyewear.  Vanity is universal.  And as I told the young woman “Las gafas no te ayudarán si no las usas" (glasses will not help you if you don’t wear them.)

Styles come and go.  I had given her very small frames, which used to be in style, but she preferred something bigger.  I went back to our stock and found a larger frame with the same prescription.  She thanked me profusely.

After our work was done, we had hoped to present each resident with a gift bag of items volunteers back home had prepared for each young person served by Hogar Agape.  But a number of neighbor children were also congregated there, and the staff quickly realized it would be too awkward.  Also, quietly and without ceremony, we slipped the superintendent a check representing the generosity of I Care members and others who support their work.  We did what we set out to do.  It was a wonderful day.

I decided to try to walk down to where the bus was parked.  When the young woman I fitted with larger glasses for her myopia saw me doing so, and perhaps noticed my awkwardness, she quickly came to my side, took my bag, clamped onto my arm, and helped me.  It gave us a chance to talk.  We spoke in Spanish, but I’m reporting our conversation in English.  

“How old are you?”

“Nineteen.”

“How long have you worked here?”

“I don’t work here, I’m a resident.”

“Really?  How old were you when you came?”

“Ten.”

“And you have lived here since?  Only here?”

“Yes.  Some of the older staff who came here as children stayed as staff, but I’m going to leave.”

“What is next for you?”

“I want to go to school.  I like it, and I get good grades.”

“What do you want to study?”

“I want to be a lawyer.”

“Do you know where you will study?”

“No.  But I know I want to leave El Salvador.”

“Where will you go?  The United States?”

“No.  Everyone talks about the United States, but I need to study in Spanish.  There are good schools in South America.  I would like to go to Chile.  Maybe Argentina.”

“Be careful here,” she said.  She pulled me across a deep rut to a smoother side of the road.

“Do you have a plan?”

“I’m putting one together.  Agape wants to help.  There may be scholarships.  Perhaps the church will help.  And I’ll work.  It may take a while, but I’m young.”

My thoughts went to resources available to young people who have grown up in the child welfare system in Illinois.  Unfortunately, El Salvador’s system is largely local and supported almost entirely by charity.  I imagined the obstacles she would face, but I also felt her determination. 

We reached the bus.  She gave me a hug and thanked me again for the glasses. 

“You have your whole life in front of you, and you have a good plan.  Good luck.  I’ll be thinking of you.”

I’m still thinking of her, and all the young people served by Hogar Agape.  There is so much need in the world, yet so much potential. Sometimes you have the privilege of seeing both closeup.  It gives me hope.    

* * * * * * * * *

During the three days following our visit to Hogar Agape, we served the people of San Alejo and its surrounding area.  San Alejo is a community of about 20,000 forty-five minutes east of San Miguel.  In contrast to San Miguel, El Salvador’s second-largest city at just over 500,000 people, San Alejo is quiet, and the people are tranquilo.  It was a pleasure serving them.  In three days, I Care provided services to nearly a thousand Salvadorans in San Alejo.  Follows is the story of just one, Ami, a nine-year-old girl accompanied by her mother.  She was a special patient.

Ami was diagnosed with both myopia and astigmatism.  Myopia is also called near-sightedness, meaning those with the condition can typically see well close up, for reading as an example, but for objects farther away, their vision blurs and is indistinct.  

Astigmatism, a deviation from the normal curve of the cornea or lens of the eye, further complicated Ami’s vision.  Astigmatism distorts both near and far vision.  Ami’s astigmatism was serious.  So much so that the optometrist examining her knew we would not have glasses that matched her needs in our stock of 6,000 used glasses we brought for the clinic.  Pronounced astigmatism demands a nearly perfect prescription to be satisfactorily corrected.  Ami fit a small category of patients that required we make custom lenses back home and deliver them back to her in El Salvador.  It’s an expensive process.  I Care does because what is more important in the life of a nine-year-old than good vision?

Both Ami and her mother were surprised and a bit confused by this turn of events.  Ami’s mother explained that she brought Ami to the clinic because she noticed her squinting and struggling to make out street signs and the like but had no idea the extent of her problem.

“Is it true that children think their vision is normal and only realize what seeing well really is when they get glasses?  I feel bad I didn’t get help for her until now.”

She was speaking Spanish rapidly and I asked her to repeat it more slowly.  Then I understood.

“Yes, it’s true.  There is no way for someone with faulty vision to know what good vision is until it is corrected.  It can’t be helped without an eye exam.”

Her eyes began to tear up.  Ami looked at her mother with alarm.  I began a story I’ve told many times in past clinics.

” In the United States, it is normal that school children get their first eye exam in grade three when they are nine.  It happened to me.  I failed that eye test at school.  My eyes were like Ami’s.  I had both myopia and astigmatism.  When I got my first pair of glasses, I walked outside the eye clinic and looked down the street at a maple tree.  I could see every leaf on the tree when before I only saw green.  It was like the world opened up for me.”

“That’s what will happen to you Ami.  For people like us, the world is a much bigger place with glasses.  And, if you are like me when I was nine, you won’t want to take them off.”

Ami’s Mom put her arm around her daughter.  I handed her my handkerchief so she could wipe away her tears.

We bring empty frames to our clinics just for this purpose.  I asked Kelly, who makes her living as an optician, to help me.

“See that little girl over there?  She’s nine and we’re going to make her custom lenses back home.  Help me find some cute frames for her to choose from that will fit her face.”

From our stash of empty frames, Kelly found eight or so frames that she thought might work, but there was a special pair she thought were special.

“Kids her age really go for these.” Kelly held up a pink pair of Juicy Couture frames.  “I bet she picks these.”

I laid out all eight frames on our worktable for Ami and her Mom to see.  Ami’s small hand went straight for the pink Juicy Coutures.

“Put them on.”

They fit perfectly.  I showed Ami her face with the glasses using my cell phone.  She smiled broadly.  Her Mom, still misty-eyed, dabbed her eyes with my handkerchief a final time and handed it back to me. 

I measured the distance between Ami’s pupils, noted it on her intake sheet with the prescription, and then adjusted the frames so they fit a tad tighter.  I confirmed the family’s home address and a good cell number, wrapped the frames up in her paperwork, and secured it all with two rubber bands.

We estimate between four to six weeks before custom-made glasses make it back to the recipient’s home country.  It’s not making the glasses that takes the time, but making sure we can deliver them safely and securely.  Postal systems in the countries we serve are not always trustworthy.  We much prefer giving custom glasses to a traveler who can deliver the glasses directly to our in-country hosts who in turn deliver them in person.  Glasses for someone who needs them that much are very precious cargo.

The young woman at Hogar Agape who received her first ever pair of glasses at nineteen, and Ami, who got her first pair at age nine, are a study in contrasts.  Ami’s mother, attentive to her family’s needs, sought us out because she suspected something was wrong with her daughter’s vision.  It would be ten years after whatever storm blew the aspiring law student’s family apart and caused her to be institutionalized until she would realize a similar benefit.   Yet in both cases, I Care International was there to help them.

Thank you all, on behalf of the people we serve, for making such work possible through your support.