About a year after I started working in the rural areas of El Salvador, I had established a clinic in a place called Valle Nuevo. The need for services was so great that we had also opened another six or seven satellite clinics in small villages nearby. We held regular meetings, general assemblies, for sharing information. It was not my idea to organize this way; it was theirs.

 

One of these assemblies was held to deal with the problem of the shortage of medicine. There were so many people needing care and so little resources. And, sometimes one clinic had plenty of one type of medicine, but not enough of another. About a hundred people came to the meeting. I had told them I could bring my medical knowledge to them, but they had to figure out how to solve these problems. I felt my role at the meeting was to listen to what they had to say and only speak when asked questions.

 

The community identified two concerns they had. The first was the shortage of medicines. The second was how to pay me. They were aware I had no money, not even enough to pay for the bus fare to get out to the country. I would often have to hitchhike. But I never would have mentioned that I needed to be paid; this was entirely their idea.

 

They decided to start charging fifty centavos, about ten cents, for each visit to the clinic.  This was a lot, as they were very poor. Twenty centavos would be for my salary, and the rest would be for medicines. Everyone was in agreement.

 

The decision they made at that assembly showed they were capable of planning for their future. The community made the decision, and I had to respect it. I was almost in tears, so moved by their wisdom and capability.

 

Even though this was a small amount of money, it added up quickly because there were so many patients every day, and there were eight clinics. I had been so focused on the work of providing health care, I never gave a thought to the sustainability of the clinics. The campesinos also formed a committee to oversee the money. We learned together how to do the administration of the clinics, keep records and accounts. I had to submit expense reports. 

 

Often I would see a patient I knew to be extremely poor, and I would tell her she did not have to pay. She would explain to me that paying for this service was a sacred duty. She had saved her pennies to pay for the visit. She said, we give money to the church, and they do not do as much for us as you do.

 

So we came to a level of organization I never would have thought possible. I had always heard that campesinos were not very bright. I had so much pity for their poverty, I underestimated them. This was the first time I understood that the community really had the power of decision. I came to realize the campesinos were naturally intelligent; that every person, poor and marginalized though they may be, has capabilities, dignity and the brains to think.