San Salvador, El Salvador June 2016

I feel that I enjoy photographing and learning stories of these families because I see much of my own pain in the children and their families. However, I was born into the privilege of exceptional healthcare, technology, resources and family. Most and many that I met with do not share this fortune. These stories beg to be highlighted.

We all ask and wonder; "what can we do about poverty?" When poverty is discussed,  several elements are especially observed that contribute to a low socioeconomic status. We know immediately that poverty describes a situation, individual or of a population, of poor education, class, wealth, nutrition, etc. We know there are endless causative factors and elements that solidify disadvantage worldwide. I believe that one of those elements that is very much overlooked is congenital defects.  We wonder, how can we alleviate some of the burden and disadvantage of poverty? On both an individual and population basis, birth defects must be noted in the way that many are caused by the effects of poverty, AND vise versa. Another link in the chain of poverty that we must pay more deserved attention to. Congenital anomalies contribute to social and economic inequality, and social and economic inequality contribute to a higher prevalence of congenital anomalies. 

My six days in the military hospital of San Salvador were, of course, constructive. However, I spent less time behind my camera than I initially thought I would. I spent most of my time with families and their children. We spoke much as I could carry with my poor, progressing Spanish. I asked them questions about their journeys, their children and how they were doing in school, where they came from and their hopes and dreams of the future. All were similar; they all knew of another individual with a birth defect similar to theirs or their child's. All want a bright future with education and a good family life for their child. All recipients would likely not have had another opportunity for these surgical procedures otherwise. Most cases  were cleft lip and cleft palate, some hand-related anomalies, and a few with Treacher-Collins syndrome and cleft-related craniofacial defects.

"Born to be brave"

"Born to be brave"

Kevin, 22, has now had seven surgeries to correct the effects of cleft lip and palate. Recovering from a surgery can be a battle, but a life without access and available treatment is a far greater struggle.

The mother and son on the left visited 3 different hospitals, of which none of the services were covered by their insurance, for treatment of an amputated fingertip. Although this situation is not related to birth defects, it highlights the difficulty of access to treatment, especially children, in an impoverished region. She will hopefully have surgery with a craniofacial surgeon (with Austin Smiles) 

The young girl on the right has a large mass behind her left eye and has lost vision as a consequence. Her brother (not pictured)  was born with an atrial septal defect (an extremely common birth defect that causes a hole in the wall between the heart's upper chambers) was fortunate enough to have had surgery when he was 2, as his health was critically declining. Their cousin, around the age of 5, has sought and is seeking treatment of her sickle cell anemia in the United States of America because the treatment for her condition in El Salvador is so poor. These stories matter.

I plan on returning to this hospital with some, if not most of the same families for a follow-up visit, in a few months. I plan to continue this work as far as it will take me, and far as the collective voices of these children will travel.