A True Leader

Dr. Vicky Guzmán, founder and director of ASAPROSAR (Salvadoran Association for Rural Health) started her work in 1972. She dared to take health care to remote, rural mountain areas on horseback, by foot, by bus or train Dr. Vicky Guzmán believed people have a right to basic health care and medical attention should not be dictated by political interests or wealth. Methodically and patiently she listened to the villagers, collected useful information about their concerns, and explored possible solutions with them. Campesino leaders were identified by their communities and trained as health promoters.

It is a story of respect and understanding of culture and traditions. Dr. Guzmán worked side by side, shoulder to shoulder with campesinos, to improve the health of people living in extreme poverty. When a child died she gathered the villagers together to discuss what had happened, what they could do to protect their other children, and answered the questions of “why?” and “how come?”

Dr. Vicky Guzmán also learned from the wisdom of the villagers. On one occasion she was almost certain an unconscious pregnant woman was suffering from the complications of diabetes. But the community refused to allow the patient to leave the village. Having no sophisticated laboratory equipment to demonstrate the problem, Dr. Guzmán gathered the leaders together to explain diabetes. Listening intently, one of the illiterate men asked, “Did you say the sugar is in the blood and in the urine?” She nodded yes. “Well, said the campesino, “You put some of her urine on the ground right here, and I’ll urinate on the ground over there. Then we can see where the ants go. If she has sugar in her urine, that’s where the ants will be.” Within minutes they watched in amazement as the woman’s urine became covered by tiny insects. Dr. Guzmán recalls that this was the first of many, many lessons she learned from the rural peasant families.

To empower illiterate and disenfranchised people was a dangerous threat to the status quo. Generations considered the rural campesinos as objects for exploitation. Dr. Guzmán was upsetting the established norm. Her actions were viewed as subversive in a political climate that soon festered into a 12 year civil war. She was followed, her workers persecuted, their homes burned, some were killed, she was imprisoned and suffered the atrocities of the war.

In 1986, following her imprisonment and house arrest, she wanted to return to her work in the country. Dr. Vicky Guzmán recognized that first she must legally establish ASAPROSAR in order to provide protection and validity for her rural health program and for the safety of her workers. Years later her personal commitment has been rewarded. Today ASAPROSAR serves approximately 140,000 persons living on the margins of society in extreme poverty.