“There will be a knock at the door,” says Rene, an El
Salvadoran Pastor and my close friend, “and they will say, ‘Give us your
daughter or we will kill you and your family’.” He continues, “Gangs control
many of the villages. They are in the schools; they are in this school! If the
leader sees a girl that he likes, no matter her age, he sends members of his
gang to her home and demand the girl be given to them to be used as the leader
decides. If the parents refuse, the gang members keep their word and take the
girl anyway. When a boy reaches the age of 10, if he does not join a gang, he
may be killed. This is one reason why many of the children arriving at the US
borders are alone, without parents, or a significant other. Their parents had
to make a decision; a decision of life or death; a last resort, gut-
wrenching decision; yet the decision becomes all too clear. It is safer for
their children to make this most perilous journey than to remain in their own
I listen in disbelief as I sit on the crumbling concrete
steps of the village school where our medical clinic is temporarily located for
the week. The village is located on the side of an inactive, waterless volcano
where large cisterns dot the mountain side collecting precious rain water for
the people’s every day needs. This is my 12th year leading medical
teams to a country and people I have come to love deeply. It has become my “segunda
casa”, my second home, yet, somehow, I have not heard this story that is the
reality for many in El Salvador. It is a beautiful country of volcanic
mountains and rock - strewn beaches. Its beauty in stark contrast to the ever-present
violence and intimidation of the gangs. Even the capital, San Salvador, cannot
escape this dark reality. Mara Salvatrucha, MS 13, are names that illicit fear
in every El Salvadoran; most of all the fear of a knock at the door.
Often, “Coyotes” will
take these children, and others willing to sacrifice everything for a chance at
a life offering a glimmer of hope, on this most hazardous trek where illness,
injury, and death are ever present. They are soul-less mercenaries who feed on
and live off this agonal reality at a precious cost to these desperate families
– of money, fractured families, and even death. To live without hope is not to
live, it is simply to exist. So, the decision is made and the children are
sent. Hope of a better life for them and their loved ones left behind a
powerful driving force.
In the villages, lacking many of the modern luxuries of the larger
towns and cities, little is known about the news of the world. For them, life
is a daily struggle of survival. They know not of the “immigration problem”
that is often front- page news in the US. They are oblivious to the polarizing
issue, with all its ugly faces, that it has become in our country. They only
know what they have always heard, that America stands for freedom, opportunity,
and most of all hope. They want that for themselves but especially for their
children. So, this heart-wrenching story is repeated over and over again and
the tears fall, hearts break, and families separated.
Many in the U.S. ask the question, “Why?” Why would parents
send their children on a potential death march? How could they ever do that?
How could they be so heartless, unloving, irresponsible? Did they not care for
their children, love their children? “I would never do that”, we all easily say
without hesitation. But, in those same circumstances, would we? Fortunately, we
do not live such a cruel reality.
My heart aches and eyes glisten. There are children at the
school now that we will see in the clinic who live in this “Twilight Zone” of
reality. I feel helpless. As a physician, I seek to comfort, treat, and heal.
As a father, I do everything I can to love and protect my children. The people
of El Salvador seek to do the same for those they love, no matter the cost, no
matter the sacrifice. May we not forget this. I never will.
Andy Lamb, MD