Serving Las Placitas

I Care International may have served patients on the slope of a volcano before, but this was the first time I was aware of it.  Known as “Chaparrastique” by the locals, but formally Volcan de San Miguel on maps, the volcano upon which we worked in El Salvador is one of the most active volcanoes in Central America.  I learned that after I got home.

I’m glad they don’t tell us these things before we go, or while we are there for that matter.  I did hear an anecdote in the clinic that gave me pause, but I didn’t pursue it.  It came from a colorful local woman I was giving glasses.

Dispensing is the final station of six that we set up at every eye clinic.  The progression is this: intake, nurses, acuity (eye charts), autorefractor (a machine that measures the eye), a thorough eye exam by an optometry student, optometrist, or ophthalmologist, and at the end the dispensary, where we give them the eyeglasses if needed.  Almost all do.  It’s why they come.

I like dispensing because it is that part in the process where improved vision is realized, individual after individual.  Sometimes the change is dramatically better.  You can see it in their faces as they look around them.  Who wouldn’t like that job?

We were located under a high roof with no walls.  We caught the breeze.  All around us were leafy tropical plants and trees.  It was one of the most beautiful clinic sites I’ve worked in.  One morning, loud booms on the steel roof above us interrupted our work.  We were alarmed.  The locals in the clinic instantly reassured us.  They pointed up and said “mangos.” 

A lot of volunteers had pre-trip worries about the heat.  Two years ago, temperatures reached 100 degrees F.  Not so in 2026.  The locals were more bundled up than us.  A cool spell brought the temps down into the 60’s and 70’s. 

Back to the volcano story.  Duolingo, a self-paced digital language program, is slowly expanding my ability to have conversations with our Spanish speaking patients. 

I began fitting a sixty-year-old woman with glasses by reading her first and last name to confirm I had the right person, but also to introduce myself.  Then I shook her hand, smiled, and told her I was glad to meet her.  That’s the most important part of the dispensing process.  The patient inevitably smiles back.  It’s a good way to start.

Next, I scanned the intake sheet, looking at her acuity score, the prescription the eye doc had written, and the glasses chosen for her. But before I started, I asked her (in Spanish) if they had problems with forest fires.

I asked because each day we took a bus ride from San Miguel, elevation 423 ft. up to La Placita, elevation 2,800 ft..  During the ride, I peered into the forest.  It looked dangerously dry.  I imagined flames sweeping up and down the slope. 

“No mucho.  Solo fuegos pequeños y no a menudo.”  Not much.  Only little fires and not often.

She went on.

“No tenemos miedo con fuegos, pero cuando Chaparrastique estallas, tenemos problemas grandes.” We don’t fear fires, but when Chaparrastique estallas, we have big problems.

“Estallas?  No entiendo la palabra estallas?  I don’t understand the word estallas. 

She held two fists tightly together in front of her chest.  Then she raised them, pulled them apart, and spread her fingers.  It was the sound she made that drove her point home. 

“POW!”  No translation needed.

Pantomime can be powerful.  Estallas means bursts.

“Ah si, claro que si.  Entiendo.”  Oh yes.  Of course.  I understand.

She nodded vigorously. 

“Que pasas entonces?  Que tipo las problemas?”  What happens then?  What type of problems?

“Ceniza y piedras. El sol se oscurece por la ceniza, y las piedras son peliogrosas.  Ash and stones. The sun goes dark because of the ash, and the stones are dangerous.

“Que tamaño tienen las piedras. How big are the stones?”

“A mi tía le atravesó el techo de su dormitorio una piedra del tamaño de una estufa.  My aunt had a stone the size of a stove crash through the roof of her bedroom.”

“Dios mio, eso es horrible!  My God, that’s horrible!”

“Estuvo bien.  Estaba en la cocina.  It was OK.  She was in the kitchen.” 

I couldn’t help but look out at the sky.

¿Cuándo ocurrió eso? When did that happen?

“Hace viente anos.  Ahora esta bien.  No te preoccupes.  Twenty years ago.  It’s OK now.  Don’t worry.

I began to laugh.  So did she.  One of the bifocals we had picked for her suited her well.  It was a five-minute encounter.  But it goes to show there is more to the clinic than glasses.

El Salvador experienced a civil war from 1979 to 1992 that resulted in 75,000 deaths (mostly civilian) and massive displacement.  Today, it's popular new young leader built and filled one of the world’s largest prisons with tattooed Salvadoran gang members.  Recently, that same prison held deportees from the U.S. as well as U.S. citizens swept up in our deportation efforts. 

But I Care doesn’t travel to countries to affect their politics.  We go to give the gift of vision to those for whom it is not available.  We helped people like these:

·      Two sisters, one on each side of their elderly mother who was barely mobile.

 ·      A very fit 79-year-old man with a machete in a leather case.  When I asked about the machete, he said that he no longer works in the fields but just feels more comfortable having it with him.

 ·      Another pair of sisters, each with two rowdy kids.  We served one sister while the other watched the four cousins, then vice versa.  I gave them all Pez.

 ·      A woman with her nearly deaf father.  When I asked him questions about his new glasses she bent down within inches of his ear and repeated my questions at the top of her lungs.  His eyes grew wide at the sound of her voice as if he had heard it for the first time.

 ·      A young mother managing her two kids alone getting her first glasses.  She was high minus, very near sighted, who was blown away at how far across the clinic she could see.  I told her kids “Mira.  Tu mama lleva lentes.  Ahora podria verte mas de cerca.  Look.  Your mama has glasses.  She can watch your closer now.”  Smiles.  More Pez.

 

We served individuals, families, a whole community of ordinary people living their lives.  We think we saw the best of El Salvador.  We hope they saw the best of us. Every mission is unique.  Las Placitas in 2026 was extraordinary.  I can’t wait to see what next year’s mission brings.