Lessons from SAMU’s Mission to El Salvador 2020

SAMU Team El Salvador

After a humanitarian cooperation mission, in many occasions the return to routine comes faster than one can process the experience. But all the memories, experiences and lessons remain in the conscience waiting to be understood. Twenty days after their return, five of the professionals who traveled to San Salvador for SAMU’s 28 day humanitarian assistance mission got together to talk about the experience. 

Some of these volunteers had not seen each other upon their return to Seville, after the welcoming ceremony organized by Escuela SAMU. Upon arrival, they give each other a warm but socially distance hello. Covid-19 continues to be present and everyone is wearing a face mask. After a couple of pictures for our SAMU Magazine, the five volunteers sit in a circle inside one of Escuela SAMU’s classrooms. Everything is quiet. There is no rush or anyone to bother. In that moment Alejandro, María, Rubén, Ignacio y Roberto reflected upon their experiences. 

The five volunteers learned about the humanitarian mission to El Salvador from the call to volunteers made by Grupo SAMU on social media and via different WhatsApp groups. They all submitted their application. Some of them had experience careing for Covid-19 patients in Seville. Ruben Izquierdo, 21 years old, had recently been part of the team at caring for elderly patients at Hotel Alcora, in San Juan de Azanalfareche, Seville. He worked as a nurse practitioner. Ignacio, an emergency technician, was part of the team in la Línea de la Concepción (Cádiz). “For me, this is a vocational job. I love the idea of helping and that also why I’m a red cross and proteccion civil volunteer.” Says Ignacio. 

Roberto is a 4th year medical student and was working as a waiter in Mallorca when he was selected to be in the mission team. “I had excellent references of SAMU. I have friends that have already worked with the organization and I didn’t think it twice. I left my job and took the first flight. Next day I was already being trained at Escuela SAMU. It all happened too fast but I made all the decisions with the support of my mother.” 

María Martín Díaz, a nurse and graduate of the Masters in Nursing for Urgent Care, Catastrophes and Humanitarian Action from Escuela SAMY and Fundación CEU San Pablo Andalucía (2018-2020), also left her job to travel to El Salvador. In her case, she had a contract at Hospital Osuna until the 31 of August. “I left my job knowing that I was going to be penalized and wont be called back for a while. They are now renewing contracts until December and I’m missing out. But I have no regrets. I wanted to go on a humanitarian mission. It was something I always wanted to do but didn’t have a chance in the past.” 

Alejandro is the youngest in our team. He is an emergency services technician and 18 years old. “When I decided to go to El Salvador I only had the support of my father, who is a firefighter and likes emergency assistance. My mother, grandfather and my sister were not excited with the idea. They were afraid of me going on a humanitarian mission at such a young age, but I decided to go ahead”.  

They all agree that the nature of this mission is different from other SAMU Missions. This was not an emergency services mission, but rather a training and support one. The team carried out a training plant in assistance, biosecurity and logistics to improve the effectiveness of the local teams. There was also a big emphasis on hands on training for bedside assistance and to the managerial positions. This knowledge transfer has actually been SAMU’s biggest legacy from their work at Hospital San Salvador. 

These volunteers also found big differences in the way that SAMU has responded to the pandemic in Spain and the operations in El Salvador. “To start, our patients were different. In Hotel Alcora we treated elderly patients but in a stable condition. We didn’t have an ICU unit. In El Salvador we had patients in critical condition” explains Maria Martin. “The ages of our patents was also different. In El Salvador we were treating patients much younger” 

“The structure and way of working was also different. Here we have the doctors, nurses, auxiliaries and technicians, all with different roles and functions. There we found many specializations within a specific role, making the work assignments harder to define’’ continues Maria “On the other hand, the experience of the professionals at the hospital in regards with Covid-19 and in the ICU with multiple patients at a time was limited.”

Alejandro recognizes that one of the most shocking aspects of the mission was the number of deaths. “I had never seen anyone die” says the 18 year old. “ Each country and hospital has its own rules and you have to adapt. But that doesn’t take away the frustration and feeling of helplessness when something is done different from what you have learned and think it’s the appropriate way. There were a lot of young cases that had a big impact on me” 

“This pandemic has taken our profession to a new limit. To many, this crisis is too impactful. Many just want to finish their shift and go home. They are overwhelmed and tired and it is completely understandable” Says Maria Martin.

“ We also admire the flexibility and capacity of change. Their willingness to improve their procedures. All of this makes us realize the great health and sanitation system that we have in Spain” Says Roberto Millares, Medical student. “On the other hand, we found that they had the right quality and quantity of resources, where all that was needed was the optimization on procedures and use of these resources”

Aside from the professional experience, one of the most impactful aspects of the mission was the overwhelming welcoming from the national government and the people of El Salvador in general. 

“Upon arrival to the airport we were warned by other passengers to expect the press to be at the airport. We thought that was an exaggeration, but as we stepped off the place and saw the government representatives we were shocked. We had a ministerial welcome” Says Roberto Millares. “As our mission director says, there were times that we were treated as rock stars and others as Madre Teresa de Calcuta” continues Maria. 

They all agree in the wonderful and warm treatment on part of the people of El Salvador. “They have taken care of us since day one. We aways had a security escort but almost didn’t notice” says Ignacio. “People stopped us on the street to say hi and the patents were very nice and thankful” 

The group also remembers the great harmony within the group of SAMU Volunteers. “We had a great bond. I was not expecting it. From my previous experiences and similar deployments I was not expecting such a great sense of community. What we experienced was a great sense of comradery”  Explains Ruben Izquierdo. “If anyone had a problem or a bad day, we would lift each other up, looking for a way to make everyone feel better. We were a family”. 

In every step of the way, these five volunteers and the rest of the team felt the strong support of the mission team back home. Although not in country, there was a group of SAMU professionals aiding them from Seville, covering their needs and keeping communications with families. “They kept track of all all the important date, birthdays and other celebrations. This really got us through the most difficult moments” Asserts Maria.  

“Mi mother said that she felt more connected and at ease with me in El Salvador that if I was in Seville or Mallorca, because of all the information and details she received from the SAMU Team. I am not the best at giving her a call” adds Roberto. “Although the team in Seville was foreign to us, they knew every details of our mission. They were the great big brother”. Adds Ignacio. 

When asked if they will sign up for a future mission, the answer was an unanimous yes. “I would have stayed longer, with some adjustments”  says Maria. “For example, adjusting our work schedules. During out entire mission, we only had one day off. We were going straight from the hospital to the hotel and had half an hour to eat. We knew exactly what we were signing up, but that rate was only viable for one month.”

“We have lived the spirit of SAMU in its purest form, even though some of our us were new the organization”, concludes Roberto. “We have learned to manage uncertainty and our own shortcomings. That the true spirit of SAMU, but you don’t feel it until you live it”. 

Arrival to San Salvador

The welcoming to San Salvador was beyond anything we could imagine. Our team is humbled and excited to begin their work. Thank you to our hosts.


Mission El Salvador 2020: Elite force against Covid-19

COVID-19 El Salvador

An intervention team from SAMU has been deployed to El Salvador in response to a call from their government to SAMU First Response at the beginning of July. The team of 28 is there to help them as they face the sanitary crisis caused by COVID-19. 

Given the situation in El Salvador, the Ministerio de Salud made an official call to Carlos Álvarez Leiva, President of SAMU, to provide assistance to a national hospital in San Salvador, the nations capital. The hospital has been recently inaugurated by president Nayub Bukele. The hospital counts with 1,000 beds of emergency and ICU support, making it the biggest hospital in Latin America. The urgent petition comes as there is a great need of volunteer medical support at all levels for at least a month. This call also comes with a need for instruction and knowledge transfer, something deep into SAMU’s mission and structure. 

To respond to the call, SAMU has gone through an intense selection process in which more than a 100 professionals from different parts of Spain have applied. On July 29th, the team of 28 professionals departed to San Salvador on a month long mission. 

The volunteers reported for duty on July 28th at the Escuela SAMU facilities in Gelves, Seville to depart to Madrid on a bus organized by our team. On July 29 they left on a charter plane to San Salvador. 

“We are a young team with a call to service and a willingness to share the institutional knowledge we have acquired during the last 30 years of missions and 20 years of training from our organization. We are eager to share the best practices that have been developed from the protocols on the fight against covid in Spain.” Says Juan Gonzales de Escalada, director of SAMU emergency services and leader of the mission. 

The departure was attended by many of our local authorities who came to wish the best to our team as they departed on this trip. Among them were Rafael García Villa, delegate from the Human Resources and Mobilization office from the local mayor’s office; Carma Tápies, Leader of the Humanitarian Action office in the Andaluza Agency of International Cooperation; Christophe Sougey De Funes, French Consul in Seville; Ignacio de Cossío Pérez de Mendoza, Consul from El Salvador in Seville; Alfonso Carmona Martínez, president of the School of Doctors in Seville; and Pilar Cordero Ramos, Vice President of the School of Nursing in Seville. 

Before the departure there were many emotional moments from our volunteers and their families as they wished them good luck and said their goodbyes. 

“As a mother I am afraid, what she is going to do is dangerous, there is a risk of contagion but I understand that is her calling and I’m here to support” said one of the relatives from our volunteers. 

As of July 29th there are approximately 270 new cases a day in El Salvador. 87% of the confirmed cases are in the nation’s capital. The Salvadorian Ministry of Health identified the first original cases of Covid-19 in the country back on April 10. At the beginning of July there were of 8,000 cases and 209 diseased. Health authorities predict the peak to hit in August and the country does not count with enough professionals to respond. 

“The call for medical volunteers will create a long lasting impact in our country. We are excited to continue building our relationship with SAMU Foundation as we all continue the fight against the virus, always improving the condition of our community” as stated by the Government of El Salvador. 

SAMU has extensive expertise in emergency interventions during catastrophes and has acquired a lot of know how in the fight against Covid-19. During the time of peak cases in Spain, SAMU was at the frontlines of the response, providing sanitary response by setting up temporary hospitals in Hotel Alcora, located San Juan de Aznalfarache in Seville, and the Residence del Tiempo Libre El Burgo, located in Línea de la Concepción, Cádiz, in order to provide medical services to elderly people with  Covid-19. SAMU also participated in the transfer of Covid patients from Madrid and Toledo. 

Close to 600 children under the protection of SAMU

The massive arrival of immigrants in small boats to the Andalusian coast in recent years has put all the social entities involved in this phenomenon on alert, among them the SAMU Foundation, which currently hosts about 560 minors who have arrived clandestinely to Spain without being accompanied by an adult. These are distributed among the 16 different centers available to the organization. On the one hand, the so-called Temporary Emergency Accommodation Units or Immediate Care centers, and, on the other, the Basic Residential Care centers. Most of them come from Morocco, although there are also children from Guinea, Senegal, Mali and Ivory Coast.

Irregular immigration has more than doubled so far this year compared to the figures of 2017, which were alarming then. Spain is already the main access route to Europe, surpassing Italy. Up to the 15th of July, the irregular immigrants who had entered this year in Spain, mostly by sea and on the coast of Andalusia, already numbered 15,686, according to data from the Ministry of the Interior —the European agency Frontex raises this to 18,016 for the same period—, 114% more than in 2017, when the figure had already increased by 170%.

Many of these immigrants are unaccompanied foreign minors. In the first seven months of 2018, some 3,200 unaccompanied foreign minors came to Andalusia through its shores, a thousand of them in July alone, compared to 2,855 in all of last year, according to data from the Andalusian Government.

This year, the SAMU Foundation, by order of the Board, has opened, as of yet, 11 new resources aimed at this group. Two of them are Basic Residential Care centers, and the rest are Immediate Care centers.

The last two emergency temporary shelter resources were opened in August in Guillena (Seville) and Jimena (Cádiz). In addition to these, there are two more in the province of Cádiz open this year and two more in 2017, two in the province of Almeria, and three in that of Granada, all of them active from this year.

In terms of Basic Residential Care resources, which allow minors to remain at the center until children reach legal adulthood, SAMU has three resources in Seville, Granada and Cadiz. The last of them was set up in El Bosque, in the province of Cádiz, at the end of May. It was born from a need of the General Direction of Childhood and Families of the Board to address the needs of minors who arrived in Spain during the year 2017 and were still being cared for in Immediate Care centers. There are 13 people who work here, among them psychologists, social workers, educators, teachers, and edudational technical assistants.

“The key objective of the Basic Residential Care centers is to insert these children into society. Our role is one of social and professional guidance that starts with the task of documenting the minors, placing them in educational centers or in different courses and working with them towards their future emancipation,” indicates Nicolas Torres, director of SAMU minors.

All these resources add up to two more instruments in Motril (Granada), a Center of Social/ Professional Orientation, opened in 2013, and a floor for children who have been under the guardianship of SAMU and who have already reached legal age.

La Caixa Foundation donates € 10,000 TO SAMU Foundation to assist in their reconstruction mission in Nepal

La Caixa Social Work has donated € 10,000 to the SAMU Foundation, contributing to SAMU’s mission in Nepal. They have been present at the signing of Insausti July D. Bono, Director of the Business Center of the Caixa and Dr. Carlos Alvarez Leiva, President of SAMU, who thanked Caixa for their support of the SAMU Foundation.

This donation will help rebuild an orphanage and create an assistance campaign for children of the orphanage and for populations in the surrounding areas. Therefore, SAMU will create an advanced medical area to help those in need. 

On May 11, the first team of SAMU health professionals left for Kathmandu with 300 kg in humanitarian necessities. 
With 5,500 units donated by Menarini Group analgesics of Spain and 300 kg of medical equipment, the SAMU team will help the wounded and the refugees of the recent earthquakes in Nepal.

SAMU sent the first medical personnnel and equipment to Kathmandu

Our first team left on Monday for Kathmandu with 6 toilets and 300 kg in humanitarian action.

About 5,500 units donated by Menarini Group analgesics Spain, together with 300 kg of medical supplies, equipment SAMU takes to help the wounded and refugees of the earthquakes that have recently taken place in Nepal. This work will target victims at increased risk such as children, orphans, disabled and chronically, especially vulnerable.

The director of the School of Emergency SAMU, Juan Gonzalez, said “these drugs are vital in the area, since its analgesic capacity is very suitable for aiding the injuries caused by catastrophes: fractures, amputations, crushing, etc … Our medical equipment is first intervention drugs, generators, multifunctional elements, transmissions and logistical resources Primea.”

Dr. Carlos Alvarez Leiva, president of SAMU, said that “our work in other missions such as the Philippines, Haiti, Indonesia, etc … has been to restore destroyed hospitals, attend to the wounded, provide babysitting, classify patients, offer primary care, and improve pediatric healthcare … with strict control of our actions under the guidance of the UN. “

“Our professionals, doctors, nurses, technicians, and pharmacists are specially trained to work in conditions of austerity, in impossible scenarios, have a balanced psychological profile and are prepared to face uncertainties. Our team’s skills go beyond just providing assistance: we are also experts in health organization and logistics”, says Carlos Alvarez.

The third contingent sent to the Philippines continues saving lives

The third contingent of Fundacion Samu sent to the Philippines came to value a man who as volunteers of the NGO commented Gualandi Volunteer Service Programme, working in the area (San Remigio, Cebu), had 16 subject tied to a tree and unaware of the motif.

When the team arrived to the area to assess it, this man was in the middle of the jungle with a foot trapped between two logs that allowed him to move but not be straight. The physical examination was normal and noted that he was careful as the mother would wash him and gave him water and rice.

After assessing the man named Ben, volunteers met with the family to find out why Ben’s behavior. The story told by family and behaviors Ben was diagnosed with schizophrenia and was prescribed a treatment that the NGO will provide.

He was taken to hospital where he spent the night and was discharged with medication. He is currently with his family at home that volunteers have rebuilt since it was damaged by the typhoon.

Maria Dolores Romero, SAMU psychiatrist, says that “the reason why the family was tied by ignorance and fear of the attitude that was showing Ben. In countries like the Philippines, especially in disadvantaged areas, there is no adequate mental health care and a significant lack of knowledge about mental illnesses that make people with a mental disorder are in inhuman conditions.”

International Meeting Crisis Management and Disaster in Curitiba, Brazil

Samu International in association with The Chains Group held the day 6-8 February in Curitiba: “The International Meeting on Crisis and Disaster Management”.

The aim is to encourage debate about the importance of prior organization to crises and disasters. This meeting will feature lectures, theoretical and practical courses, also will be launched in the Brazilian country in the second edition of the book by Dr. Carlos Alvarez Leiva: “Atendimento de Saúde em to Multiple Frames vitimas and Disasters”.

Dr. Alvarez Leiva made two free and open to the public about the book and the management structure of global crisis brought to Brazil for the event talks.

The course content will include: Risk Management, a systematic view, introduction to crisis management, health teams in events and disasters, the role of universities in scientific research on disasters and major events, disaster medicine, hospital and disasters and crisis cabinet and SCI.

About the World Cup, the president of Samu stressed the ability to mobilize the Brazilian people. “The people of this country is prestativa solidarity and an event with these proportions is the opportunity to improve the care and services they need to integrate and prioritize an organization and efficient logistics.

The SAMU team has participated in the rescue of a ferry in Santa Fe, Philippines, which has resulted in several injuries

The SAMU team participated in the rescue of a ferry in bad weather, he could not reach port.

After controlling the chaos caused by the nerves of the passengers, we proceeded to landing, with neither the captain nor the crew appeared throughout the operation.

When the landing was finalizing appeared the captain decided to return to port and sailed back to those who had already been evacuated. They reembarked passengers from the ground in an operation that was back uncoordinated but this time with the presence of the captain and the Coast Guard in the rescue. One of the vessels was about to re-embark, with too many people on board capsized some 50 meters from the boat, with passengers trying to hold on to the tack boat.

The situation became more dramatic after the turn of the vessel, but the speed of the Vbert volunteers and fishermen rescue craft, they had no problem jumping into the water at any height, made this incident was resolved in half an hour. A pregnant woman, a blind and a paraplegic girl who had respiratory problems and slight chest pain were attended, among others, the medical team SAMU.

The mayor has deeply grateful to the SAMU team the great work done throughout the rescue.