Category Archives: El Salvador

Interview: An AmeriCares Doctor in El Salvador on Family Care

Emma Cannon
by Emma Cannon, Latin America and Caribbean Intern at AmeriCares

When Dr. Nancy Melgar from La Clínica Integral de Atención Familiar, AmeriCares Family Clinic in El Salvador, visited the Stamford headquarters, I was lucky enough to interview her and hear her fascinating story: from showing a passion to become a doctor at a young age when she would cure her dolls to studying medicine in El Salvador and Cuba to finding her calling in the field of humanitarian work with AmeriCares.

The Gaps in El Salvador’s Health Care

Apart from her inspiring story, Dr. Melgar spoke about the structure of the health care system in El Salvador, giving me a better picture of where the clinic fits into the national framework. She explained the clinic fills a large gap in publicly-funded primary care for communities that do not fall under the reach of the Ministry of Health’s basic care initiative.

“Curanderos,” or traditional healers, also fill the gap in access to basic care. These healers don’t have technical medical training, but they are well respected, and a significant part of the population uses them for their medical needs.

Dr. Nancy Melgar is pictured here on the far right with fellow staff and AmeriCares staff visitors
Dr. Nancy Melgar is pictured here on the far right with fellow staff and AmeriCares staff visitors

Dr. Melgar said it is common for children to die of preventable diseases because they were brought to a curandero for healing when a medical clinic or institution could have provided treatment.

When I later researched the national health care framework, I found that El Salvador is one of few Latin American countries considered to be in crisis because the country lacks a sufficient quantity of health care professionals for the population’s needs. Moreover, roughly 35 percent of Salvadoran households live in poverty and don’t have access to health care and education.[1]

How Dr. Melgar is Helping Fill the Gaps

With knowledge of this health care system challenge, among many others due to a lack of desired coordination, Dr. Melgar and the clinic staff intend to help create a strong, sustainable network of communication within El Salvador’s health care system. This communication is vital to closing of gaps in primary care and preventing mortality from treatable causes, particularly for these children.

An important part of improving the system’s effectiveness for Dr. Melgar is also the clinic’s educational programs. These programs help to inform the communities who visit the clinic about the importance of receiving basic care. She and her director, Dr. Quijano’s motto is:

“No dar por dar, que valoran su salud.”

This means, [inlinetweet prefix=”” tweeter=”@americares” suffix=”~Dr. Melgar #quote”]”Do not just treat patients, but make them value their health.”[/inlinetweet]


Her testimony exemplifies the important crux between providing care and providing educational programs on prevention and treatment. By promoting communication with players in the national health care framework and working on grassroots education programs that will support individuals in advocating for their and their loved ones’ health, Dr. Melgar’s, the clinic’s, and AmeriCares work is geared toward strengthening the health care system in El Salvador from the top down and the bottom up.

This way, individuals such as the children whose deaths may be prevented by basic medical treatment can receive the care they need.


[1] Annex 11. El Salvador. World Health Organization. Accessed June 23, 2014.

Improving Health in Rural El Salvador

In El Salvador, TOMS Giving Partner AmeriCares distributes new TOMS Shoes to children to add value to their work, particularly in promoting good health practices in rural communities. AmeriCares believes that teaching people how to help children thrive and stay healthy is an investment that will pay off in better community health for years to come.

AmeriCares team in El Salvador works every day to empower people to practice good health and hygiene and to seek out ways of healthier living. In 2003, AmeriCares opened a full-service family health clinic in rural Santiago de María, the organization’s first clinic outside the U.S. The facility provides quality primary and specialty health care services to underserved families from many regions of El Salvador.

“Good health is essential to a thriving community,” explained AmeriCares’ Marta Cruz. “At our clinic, we work to educate people in the community to care for themselves and their families.”

The clinic is also an important source of health information for the community. Clinic employees encourage residents of Santiago de Maria to identify health issues they would like to learn more about, then the staff holds community health fairs on those topics. Last year, more than 45,000 people attended health education events on nutrition, diabetes, hypertension, prenatal care and prevention of chronic diseases and infections and more.

AmeriCares believes that educational outreach is a critical component of primary health care, strengthening disease prevention in the communities served by the clinic. It is through education events that new TOMS are distributed to children whose parents attend the fairs. Combined with quality education on health issues, AmeriCares has seen that TOMS are having positive impact in the communities and schools where they are distributed.

“When TOMS are given at our community health fairs, we are seeing improved attendance at our health fairs, which is leading to improved health in Santiago de Maria,” Marta said.

 Because of incredible organizations such as AmeriCares that distribute TOMS to children, the One for One movement is having a lasting impact on communities around the world through health, education and self-esteem. It is through our Giving Partners’ diverse integrative programming that TOMS is able to participate in responsible and sustainable giving.

This blog post was written by the staff at TOMS Shoes and published here in their TOMS Stories blog on December 4, 2013.  AmeriCares is a TOMS Shoes Giving Partner, distributing new shoes to children in need in several countries around the world.

An AmeriCares Sample Pack

After a week of my internship at AmeriCares, I found myself swimming in a pile of papers, project proposals, and pamphlets. I had abandoned taking notes almost entirely—there was too much cool stuff to write down anyway. With 3,000 local partners worldwide in 90 countries, the global reach of Americares is both interesting and complex.

So, for you, I have compiled the “AmeriCares 7-Dose Sample Pack” — small doses from the AmeriCares portfolio that provide a wider insight into the complexity of the work we do.

Dose 1: Constantly Truckin’ Along

AmeriCares sends an average of 10 aid shipments each day by air, sea and road – and each year our warehouse in Stamford, CT turns over 9 times. This means the warehouse, which is 51,800 square feet, is filled with completely new medications and supplies 9 times a year. To give some perspective, this warehouse is larger than an NFL football field, which is only 43,560 square feet!

Dose 2: Affordable Health Care on the Homefront

AmeriCares operates 3 free clinics across the state of Connecticut, and will soon open a fourth – bringing quality, compassionate health care services to the uninsured and underinsured in AmeriCares home state. The clinics have permanent locations in Bridgeport, Norwalk, and Danbury; the new clinic will be located in Stamford, CT. Simple impact math: each DOLLAR given to the clinics provides FOUR DOLLARS worth of medical care.

Dose 3: A Primary Care Hub in India

At 12 locations over 15-day cycles, families living in the congested slums of Mumbai receive a unique opportunity—an opportunity to receive quality health care and free medication from mobile medical clinics run by the AmeriCares India team. In the most recent year of operation, the clinics provided care to 36,000 patients. But, this is only a small fraction of our work in country. Across India AmeriCares serves an estimated 10 million people in 21 Indian states with the help of 55 partner organizations. From the mobile clinics in Mumbai to disaster relief in Uttarakhand, Americares is there ready to support health care in India.

Dose 4: Combating Cancer in Cambodia

Through a partnership with AstraZeneca, AmeriCares is working in Cambodia to combat breast cancer — the leading cancer killer of women worldwide. At the Sihanouk Hospital Center of HOPE in Phnom Penh, breast cancer treatment is coupled with caregiver training and patient education programs. The comprehensive initiative aims to raise awareness, improve early detection, and increase survival rates. In Cambodia, where an alarming number of women die each year as a result of breast cancer, often due to lack of awareness and high cost of treatment – this program makes a lifesaving difference.

Dose 5: Famines, Floods, and Cholera

Disaster—the word is both ambiguous and broad. But, when famine was declared in the Horn of Africa, AmeriCares was there with enough crucial medicines, supplies, and water purification to reach 180,000 people. When catastrophic flooding struck Pakistan, displacing more than 2 million people, we delivered more than $6 million in emergency aid. As cholera outbreaks occur across the globe, we combat the disease, which spreads rapidly in crowded camps after disaster strikes, by delivering treatments and supporting prevention training in Haiti, the Horn of Africa, Sierra Leone and worldwide.

Dose 6: Healthy Steps with TOMS Shoes

Health goes beyond taking the right medications and making the right appointments. For the children coming to the AmeriCares family clinic in El Salvador, good health continues with a new pair of TOMS Shoes. Since 2010, AmeriCares has worked with TOMS to deliver new shoes to impoverished children in several countries around the world — including Uzbekistan, the Philippines, Armenia, Guatemala, and El Salvador. Through its socially conscious One for One® model, the new TOMS Shoes these children receive will be replaced as they grow, to protect them from cuts, infections and soil-transmitted ailments like hookworms. Today, the children can tread softly and more safely toward better health.

Dose 7: When the Pain Doesn’t Wash Away, AmeriCares is There

Hurricane Sandy wreaked havoc on the East Coast —but just because the storm has passed does not mean that the devastation is over in the hearts and minds of survivors.

“Mental health services are often one of the most significant unmet needs after a disaster of this magnitude,” explained Garrett Ingoglia, AmeriCares vice president of Emergency Response. We’ve supported several programs that address this need – including counseling programs run by the YMCA in two-hard hit areas to help children cope with anxiety and trauma. Similar programs continue in Japan, to promote the mental well-being of survivors of the 2011 earthquake and tsunami. These programs are a crucial part of the recovery after the initial emergency response.

#FirstWorldProblems vs. #RealWorldProblems

#FirstWorldProblems: This popular Twitter hashtag highlights the most pressing problems faced by society today. Or does it?

The hashtag appears in up to 6 tweets per second and approximately 518,000 out of the estimated 400 million tweets per day. The nationality with the greatest number of people using this hashtag: American.

For most people, #FirstWorldProblems expresses the ironically “devastating” problems that users in the developed world face on a daily basis. Others don’t realize the irony of their words. For example:

“#FirstWorldProblems: I get over allergy season only to get a sinus infection.”

“#FirstWorldProblems: Oops forgot the hashtag for my possibly fractured toe!”

But to those who claim to be fully aware that what they’re saying is not a pressing issue and merely humor, the real question is: why waste time tweeting about a non-important issue when there are so many real problems in the world?


#RealWorldProblems: More than 1/3 of the poorest people in El Salvador lack access to both public and private medical care.

Here at AmeriCares, I learned that medicine prices in El Salvador are some of the highest in the region. Worse yet, the leading health problems and causes of death in the country are conditions like heart disease, respiratory infections, cancers, HIV/AIDS and digestive disease – conditions that require medications that are too expensive for most people. The AmeriCares Family Clinic is committed to providing quality primary health care to El Salvadorians who cannot afford it. The clinic, which celebrates its 10-year anniversary this year, provides quality primary care to more than 3,000 patients each month.


#RealWorldProblems arise even here in the United States. In May 2013, tornadoes ripped through Oklahoma, killing 48 people and leaving thousands homeless and at risk for diseases like tetanus. AmeriCares was there the very next day, assessing what medicines and supplies were needed and connecting with partner organizations in the area. In the first month after the disaster, AmeriCares delivered $3.5 million in aid — enough to reach 20,000 people in need.


“#FirstWorldProblems: My food gets cold so fast when the AC is on.”

“#FirstWorldProblems: We always get fat free and skim milk at our house, that 2% tastes funny.”

#RealWorldProblems: In Cambodia, 44% of children under the age 5 suffer from stunted growth due to poor nutrition.


In nearly half of the 10.9 million child deaths each year, poor nutrition is a factor. In Cambodia, child malnutrition rates are among the world’s highest. Malnourished children have a reduced ability to resist infection, making them less likely to survive common diseases including pneumonia, malaria, measles and diarrhea.

AmeriCares works with partners around the world to supply fortified, high-calorie meal packs to support programs that help thousands of patients achieve major reversals in malnutrition. In Cambodia, the body mass index (BMI) of 9 out of 10 children in the program improved enough to no longer be classified as underweight.


“#FirstWorldProblems: Trying to find a $5 bill but can only find $10s $20s $50s and $100s.”

“#FirstWorldProblems: Lol I randomly find $20 bills in my room but I just put them back bc I have nothing to do with them.”

#RealWorldProblems: Over 75% of Ethiopians live on less than $2 a day.

How can families in developing countries like Ethiopia stay healthy and well-nourished on such a meager income?  In my work here at AmeriCares, I’ve learned a lot about the #RealWorldProblems brought on by poverty, hunger, disaster and inadequate access to basic medical care. From Asia to Africa to South America, there are real problems everywhere, problems that AmeriCares is working to address to help people in El Salvador, Cambodia, Ethiopia, the U.S., and in all corners of the world.

Empowering a Community, One Person at a Time


A young patient and her doctor at AmeriCares El Salvador International Health Clinic.

Imagine this: Your name is Lina. You’re a 6-year-old girl living in Santiago de Maria, El Salvador.  Your family income is below the poverty line, and the public health system is neither efficient nor easily accessible. As a result, you suffer with health issues such as dengue fever, undernourishment, hepatitis and the common cold – conditions which are treatable — yet neither your family nor your community has the resources necessary to help you get well.

You’re often sick, and school becomes difficult to attend. Although you love school, you can’t pay attention during math because your tummy hurts and you don’t have the energy to focus.  You become more susceptible to disease and you can’t complete grammar school. Eventually, your life becomes a vicious cycle illustrated by this equation:

 Poor health + Little schooling = Low human capital
 Low human capital + Inadequate state infrastructure = Few chances to improve quality of life

Now, let’s turn this around.

Imagine this: You’re Lina, a 6-year-old girl, living in Santiago de Maria, El Salvador. Your community has a health clinic — La Clínica Integral de Atención Familiar — established by AmeriCares, that has helped underserved families like yours for 9 years. As a result, you have been going to the clinic since you were a baby. While growing up, you’ve faced several health issues such as dengue fever, undernourishment, hepatitis, and the common cold, but thanks to the health education and medical care provided at the clinic, you have been able to combat these diseases.

You’re strong, healthy, and you absolutely love going to school! You are a star student in your class and you help your fellow classmates understand the lessons too. Due to your passion for math and for serving others, you dream of becoming a math teacher.

 So — what does this mean for Lina’s future?

Because Lina has been going to AmeriCare’s health clinic, she will be able to finish her primary education. Hopefully, she will also be able to attend secondary school and eventually, university to pursue her dream of teaching. Lina now has the opportunity to make a positive impact on her community and country. She’ll be able to educate others, lead a healthy life, and provide for a future family that will, hopefully, be as happy and healthy as she is and work to build a healthier and safer El Salvador for future generations.

AmeriCares Clinica Integral de Atención Familiar

AmeriCares El Salvador International Health Clinic has been operating in Santiago de Maria since October 2003. Since its opening, the clinic has seen an average of 30,000 people per year. The clinic assures quality health care to underserved families and provides health resources and outreach to parents and families. The clinic provides primary care, pediatrics, gynecology, dentistry, and health education outreach, to help families like Lina’s lead healthier, stronger, and better lives for themselves, their communities, and their country.  Learn more about the clinic here.