As many of you have already heard, the local cuisine and an accidental dose of tap water* finally caught up with me, and I had a unique opportunity to do some ‘participatory research' into the conditions of the local health clinics!

I will spare you all the details, but suffice it to say that it all started when I woke up on Monday morning throwing up uncontrollably, and all the other ill effects of a terribly upset stomach... This continued non-stop for nearly two hours, during which my local guide and host Churro called the doc who said to come to the clinic right away... My relief over the prospect of getting medical attention quickly waned once we got to the clinic, however...

The local clinic is in every way reminiscent of the worst kind of third-world health facility that you can imagine. The building is dilapidated and half in ruins (or more likely only half built up...), with the hours and days of different specialists (who only come once a week) painted in rough letters on the outside walls. The floors were filthy, the benches in the ‘waiting room' mostly broken. Mothers with young toddlers sat fanning themselves with pieces of paper and cockroaches scurried across the floor. The only toilet there had no seat, no back and was cracked so that the water was leaking out onto the floor. It didn't flush. There was a bucket under faucet in lieu of a piece of pipe that was missing a chunk. The door was hanging on only one hinge and didn't close. It was truly horrifying and despite being beyond dizzy, unfathomably nauseous and in a cold sweat, I did think to myself that, anthropologically speaking, I ought to be taking some field notes!

The local doc was very kind, as was the ‘nurse' - despite the fact that her pointy high heels, too-tight, low cut jeans, tight yellow top that none of us would let a teenage daughter out of the house in, and bright red fingernails didn't inspire much confidence. I was given the VIP treatment, being a foreign student and all, and was put in a separate 'room', behind a section of wall. It was very hot. No fan. No windows.

After inspecting me the doctor sent Churro to go get my medication from a nearby pharmacy. This is the way it works: you come in, get inspected, and then a family member or friend has to go buy whatever you need and bring it back to the clinic. Everything from pills to injections needs to be bought by you as you need it. There are no actual medical supplies at the clinic. The injections are sold in small dark brown glass bottles, void of any kind of label or other marking, and are filled by the pharmacist when he fills your order. (I guess you can only hope the pharmacists is trustworthy and isn't filling the vile with who-knows-what). The vile comes with a needle and syringe, individually wrapped like in a hospital. Pills are sold individually, without the box or the instructions. For people who are poor, paying only for exactly how many pills you need does seem to make sense, although not having the warnings and dosage information can be a problem.

If you can't pay for what you need, then you're out of luck. While your family members and friends round up the money to buy your treatments, you lie there and wait. In the heat. With no windows. Horrifyingly dizzy, unfathomably nauseous, in a shivering cold sweat. Throwing up and needing desperately to use the toilet, which is, of course, not an option. Are we having fun yet?

After a few hours in the local clinic and without any kind of improvement in my condition, I began to worry seriously about losing consciousness and had Churro call my study-mate Anna, who was truly amazing and jumped in a taxi straight away. You can only imagine my relief at seeing a fellow ‘westerner' there! Together with Anna we decided it was better to transplant myself to a clinic in the city, and upon the advice of a good friend (another fellow westerner) we took a taxi to the emergency clinic at a hospital in the affluent Liman district of San Isidrio.

The contrast was beyond striking, highlighted immediately by the young girl sitting next to us in the waiting room - pristinely dressed in a white Nike tennis outfit (complete with a little white tennis skirt, white sneakers, and white socks with pompoms on the back) and sporting a perfect pony tail, a dainty silver arm bracelet, braces and a swatch watch, she was for me at that moment the epitome of the vast gap between the two worlds I was experiencing that day. Needless to say, the clinic in San Isidrio was spotless, sterile, air conditioned and efficient. I was treated there with an infusion and given ‘real' medication.

Incidentally, had someone from Villa el Salvador come to the San Isidrio facility, I am not entirely sure they would have been received so well...

I do apologize for the length of this saga, but somehow I felt it deserved a bit more attention.

All the best,

ammanjah. xx.

* One of the girls in the theater group had 'borrowed' my bottle of mineral water out of the refrigerator and very kindly filled it back up for me... with tap water! Of course, I didn't hear about this until I was enthusiastically gulping it down after a hot excursion outside... 'Oh, that's your bottle - I hope you don't mind, but I drank it yesterday and filled it back up for you :)'... uhh.. ohhh... :(