Difference between pages "EMA" and "Health care and safety in El Salvador"

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Many of the countries in the Europe, Mediterranean,
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{{Health_care_and_safety_by_country}}
and Asia (EMA) region are undergoing rapid economic
 
and social changes while striving to play a larger part in
 
the global economy. Challenges to this growth include
 
outdated technology, unstable monetary systems, and
 
the growing pains associated with adapting to free-
 
market economies. Volunteers in the EMA region have
 
worked to support growth and stability by assisting
 
with strengthening English language teaching, offering
 
practical business skills, generating environmental
 
awareness, and improving health education. More than
 
50,128 Volunteers have served in the region since 1961.
 
At the end of fiscal year (FY) 2007, EMA expects to
 
have 2,088 Volunteers and trainees working in 19
 
countries.
 
  
The safety and security of the Volunteers and staff
 
are the top priority in the EMA region. Training is an
 
important component to ensuring that Volunteers are
 
aware of safety and security policies and procedures.
 
The region recognizes that safety is best assured when
 
Volunteers are integrated into their local communities,
 
respected and protected as extended family members,
 
and viewed as contributors to development. Each country
 
monitors safety and security according to agency
 
guidelines. In 2006, the region’s programs in East
 
Timor and Bangladesh were suspended for safety and
 
security reasons, and subsequently closed.
 
  
Volunteers play many roles and work in a variety
 
of settings, working with governments, local organizations,
 
and communities to provide needed technical
 
expertise and to promote cross-cultural understanding
 
in programmatic areas identified as critical in each
 
host country.
 
  
All Peace Corps countries in the EMA region have
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The Peace Corps’ highest priority is maintaining the good health and safety of every Volunteer. Peace Corps medical programs emphasize the preventive, rather than the curative, approach to disease. As a rule of thumb, good healthcare comes from good health maintenance. The Peace Corps in El Salvador maintains a full-time medical officer who takes care of Volunteers’ primary healthcare needs. Medical services, such as testing and basic treatment, are also available in El Salvador at local, American-standard hospitals. If you become seriously ill, you will be transported to either a medical facility in the region or to the United States.  
identified education as a priority. Volunteers are part of  
 
national and local efforts to strengthen primary, secondary,
 
and university education capacity through classroom
 
instruction, professional development for teachers, and
 
by promoting resource and community development.
 
Volunteers help students develop their English language
 
competence as well as critical thinking skills. Through
 
team-teaching and teacher training courses and workshops,  
 
Volunteers help new and experienced instructors
 
learn new teaching methodologies and provide ongoing
 
support that boosts teachers’ confidence and fluency to provide more interactive, learner-centered instruction.  
 
  
Volunteers and host teachers work collaboratively
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===Health Issues in El Salvador ===
to develop curricula and materials for special education,
 
environmental awareness, American studies, and
 
other content-based courses. They facilitate lessons
 
and extra-curricular activities that focus on life skills,
 
decision-making, healthy choices, and developing
 
personal and professional skills. They work alongside
 
people of diverse ages, ethnicities, and socio-economic
 
status to explore individual and community needs.
 
These needs include learning how to use computers
 
or acquiring employment skills, organizing sports
 
teams, upgrading local facilities, writing résumés, or
 
preparing for international competitions. Volunteers
 
are often catalysts for getting youth, teachers, and community
 
members involved in service learning as they
 
reach out to people in orphanages, hospitals, minority
 
villages, and centers for the displaced, homeless, and
 
those with special needs.
 
  
During the last 10 years, business projects have
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Major health problems among Peace Corps Volunteers in El Salvador are rare and are often the result of a Volunteer not taking preventive measures to stay healthy. The most common health problems are mostly minor ones that are also found in the United States, such as colds, diarrhea, hemorrhoids, constipation, sinus infections, skin infections, headaches, ear infections, dental problems, minor injuries, sexually transmitted diseases (STDs), adjustment disorders, emotional problems, and alcohol abuse. These problems may be more frequent or compounded by life in El Salvador, because certain environmental factors here raise the risk and/or exacerbate the severity of illness and injuries.  
evolved from those focused on promoting small business
 
startups and consulting to projects that work
 
broadly with business issues—with entrepreneurs, governmental
 
and nongovernmental agencies, educational
 
institutions, community groups, and individuals.  
 
  
Volunteers live in their communities for two years,  
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The most common major health concerns in El Salvador are malaria, rabies, tuberculosis, dengue fever, typhoid, intestinal parasites, upper respiratory infections, hepatitis, and HIV/ AIDS. Because malaria is endemic in El Salvador, anti-malarial medication (aralen)is required. You will also be vaccinated against hepatitis A and B, typhoid, rabies, tuberculosis, and diptheria. Many of these health concerns can be easily avoided by using common sense and following basic preventive practices.  
so they are uniquely able to integrate themselves and
 
earn the trust and respect needed to be accepted as
 
valued partners and mentors. Earning that trust is
 
particularly vital to business development Volunteers
 
who consult on what are often basic issues of money,  
 
planning, and survival. There is a wide diversity in  
 
EMA countries, so some Volunteers work with illiterate
 
villagers while others work in countries about to join
 
the European Union (EU). Regardless, in each country,
 
Volunteers use formal and nonformal education to
 
help community members build basic business skills,  
 
improve communication, network, develop organizational
 
capacity, access and use available technologies,
 
and develop life skills.  
 
  
Business development Volunteers are engaged
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===Helping You Stay Healthy ===
at the grassroots level in their respective countries,
 
working increasingly with underserved populations,
 
women, and youth. They also work across sectors
 
when their business and organizational skills complement
 
those of health, environment, and education Volunteers. Issues of sustainability, transparency,
 
and community participation continue to guide
 
project development, particularly as posts seek to
 
work in more rural areas with great needs and few
 
resources.
 
  
Peace Corps projects in the region continue to  
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The Peace Corps will provide you with all the necessary inoculations, medications, and information you need to stay healthy; however, you must accept responsibility for the appropriate use of the information and medication provided. Upon your arrival in El Salvador, you will receive a medical handbook. At the end of training, you will receive a first-aid kit with supplies to take care of mild illnesses and first-aid needs.  
explore the integration of information and communication
 
technology (ICT) at all levels of project planning
 
and implementation, and Volunteers make major
 
contributions toward closing the global “digital divide.
 
They provide guidance to communities on incorporating
 
ICT into business, education, and community
 
development projects. Capacity-building efforts
 
concentrate primarily on training people to use basic
 
software applications, such as word processing, spreadsheets,
 
and databases. While many Volunteers conduct
 
skill-building exercises, others expand their work by
 
focusing on training of trainers. Several Volunteers
 
specifically incorporate activities that promote girls’
 
and women’s use of technology. Volunteers have also
 
established Volunteer-led ICT committees and taught
 
community members to use videos, newsletters, and
 
audiotapes in product development.  
 
  
A Volunteer in Jordan, working with the teacher in
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During training, you will have access to basic first aid supplies through the Peace Corps medical officer. However, you will be responsible for your own supply of prescription drugs and any other specific medical supplies you require, as we will not order these items during training. Please bring a three-month supply of any prescription drugs you use since they may not be available here and it may take several months for new shipments to arrive.  
a special education school, used computers to enhance
 
the school’s curriculum and training. Using a small
 
project assistance grant, three computers and peripheral
 
equipment were purchased and training sessions
 
scheduled. After receiving basic computer training, the
 
teachers trained their students to use the computers.
 
The teachers are using computer technology to monitor
 
attendance, send out correspondence, and develop new  
 
curricula, and the students, all of whom have special
 
needs, are accessing academic programs on the computers
 
and using them for self-directed study.  
 
  
Half the population is younger than 25 in more than
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You will have physical examinations at mid-service and at the end of your service. If you develop a serious medical problem during your service, the medical officer in El Salvador will consult with the Office of Medical Services in Washington, D.C. If it is determined that your condition cannot be treated in El Salvador, you may be sent out of the country for further evaluation and care.  
half of the countries of the EMA region. Consequently,  
 
youth development activities are increasingly important.
 
Projects that develop the assets and capacities
 
of young people are underway in Bulgaria, Jordan,
 
Mongolia, Morocco, the Philippines, and Ukraine. It is
 
more critical than ever for young people to have positive
 
channels of economic, social, and political opportunities.
 
Volunteers help young people and their communities
 
view youth as an important asset in facilitating
 
positive change. They engage and prepare youth for
 
their roles within family life, the workforce, and as active citizens. Important areas of activity include life-
 
skills training for employment, entrepreneurship, and
 
leadership; and promoting tolerance, self-esteem, and
 
conflict resolution. In one emerging area, Volunteers
 
are working with youth on journalism-related activities
 
and partnering with youth on community development
 
projects. In all of the areas in which Volunteers work
 
with youth, they advocate for youth participation in
 
their communities using effective methods such as
 
service-learning programs.  
 
  
Many Volunteers work with young people in the
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===Maintaining Your Health ===
classroom or through after-school clubs to support
 
school-to-work transitions and to make learning
 
relevant to real-life priorities. Some Volunteers use
 
English language instruction in camps or clubs to teach
 
important life skills. Other Volunteers work with marginalized
 
young people to build their capacity to create
 
a positive future in a region where human trafficking,
 
street children, drug and alcohol use, prostitution, and
 
lack of schooling plague youth.
 
  
Health Volunteers in the EMA region continue
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As Peace Corps Volunteers, you must accept a certain amount of responsibility for your own health. Proper precautions, if taken, will significantly reduce your risk of contracting serious illness and sustaining serious injury. The old adage, “An ounce of prevention …” becomes extremely important in areas where medical diagnostic and treatment facilities are not up to standards of the United States.  
to educate individuals, households, service providers,
 
and communities about the importance of health  
 
promotion and disease prevention. In addition to
 
other sector area projects with health components,
 
Albania, Armenia, Moldova, Mongolia, Morocco, and
 
Turkmenistan support distinct health projects that
 
emphasize preventive health education as an important
 
component of healthy lifestyles and improved quality
 
of life. Volunteers and their counterparts strengthen
 
different aspects of health education not only at health
 
clinics and hospitals, but also in day-care centers,
 
schools and universities, and local community organizations.
 
Their assignments encompass the design of  
 
health education materials as well as the delivery of
 
these messages with an emphasis on behavior change.
 
Health education topics include pre-and post-natal
 
care, personal and environmental hygiene, nutrition
 
and food security, and preventing sexually transmitted
 
diseases, including HIV/AIDS.  
 
  
Working in schools, with youth groups, and with
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It is critical to your health that you promptly report to the medical office or other designated facility for scheduled immunizations, and that you let your medical officer know immediately of significant illness and injuries.  
nonprofit organizations, Volunteers promote a greater
 
understanding of local ecology and environmental
 
issues. Although the specific issues addressed in
 
these projects vary greatly among countries, there is  
 
some overlap in activity types, as Volunteers increase
 
awareness through eco-clubs, camps, and tree-planting campaigns. Volunteers also address coastal issues,
 
recycling, and small animal husbandry. They help
 
improve cook stoves and train park guides. Volunteers
 
who teach English as a second language (TEFL) also
 
take on environmental awareness projects as secondary
 
activities. In Romania, for example, they helped
 
organize an agricultural fair which drew an estimated
 
10,000 visitors. More than 60 community volunteers
 
gave their time to the festival, which included 10 seminars
 
on agricultural themes and provided 35 exhibitor
 
stands for agriculture companies.  
 
  
To ensure a project’s sustainability, gender roles
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The most important of your responsibilities include:
must be considered at all levels of project planning
 
and implementation. Volunteers across sectors receive
 
training in participatory approaches to project planning
 
and community development. These approaches
 
help increase community members’ participation in the
 
decision-making processes that affect their lives. This
 
is especially true for women and youth. At in-service
 
trainings, community members and Volunteers learn
 
to use tools that aid in designing and implementing
 
community projects to include a gender perspective.
 
  
In addition to integrating a gender perspective
+
Adherence to recommended standards for food and water preparation. Many diseases that afflict Volunteers worldwide are entirely preventable if proper food and water precautions are taken. These diseases include food poisoning, amebiasis, giardiasis, hepatitis A, dysentery, worms, tapeworms, cholera, and typhoid fever. Your medical officer will discuss specific standards for water and food preparation for El Salvador during pre-service training.
from the outset of their activities, Volunteers and  
 
  
their host country partners often focus projects on
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Strict adherence to recommended drug regimen for the prevention of malaria. Malaria is endemic in most areas of the Peace Corps world. For all Volunteers serving in malaria endemic areas, or for those traveling in malaria endemic areas, it is extremely important to fully comply with the recommended drug regimen to prevent malaria. Malaria can be rapidly fatal in people who have no natural immunity to the disease. Peace Corps Volunteers who do not fully comply with the required preventive regimen may be administratively separated. Your medical officer will discuss specific recommendations for the prevention of malaria in your area.  
empowering girls who are often more disadvantaged
 
than boys, especially in the areas of education, leadership
 
skills, and self-esteem. The highest percentage of
 
girls’ and boys’ leadership camps is in the EMA region.  
 
These camps provide a format for a wide variety of  
 
topical, leadership, and empowerment activities for
 
girls and boys.  
 
  
In addition, every post in the EMA region is a  
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Prompt reporting to the medical office of any possible exposure to rabies. Rabies is present in nearly all Peace Corps countries. Any possible exposure to a rabid animal must be reported immediately to the medical office. Rabies exposure can occur through animal bites, scratches from animals’ teeth, and contact with animal saliva. Your medial officer will take into consideration many factors to decide the appropriate course of therapy necessary to prevent rabies. Rabies, if contracted, is 100 percent fatal. All necessary rabies immunizations will be given by the Peace Corps medical office and only the Peace Corps medical office.  
source, transition, and/or destination country for
 
human trafficking, so anti-trafficking efforts are a high-
 
priority development issue. Anti-trafficking committees
 
have been established in Albania, Macedonia, and
 
Mongolia to assist Volunteers interested in contributing
 
to reduction efforts by researching and developing best
 
practices and possible programs that target youth.  
 
  
As a whole, the EMA region strives to continually
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Use of an effective means of birth control. Volunteers are expected to adhere to an effective means of birth control to prevent unwanted pregnancies. Your medical officer can help you decide on the most appropriate method to suit your individual needs. Contraceptive methods are available without charge from the Peace Corps medical office.  
develop and refine its programs and Volunteer projects
 
to address the current development needs of host
 
countries, to ensure that Volunteers gain a broader
 
understanding of other cultures, and that other cultures
 
gain a better understanding of the United States
 
and its diversity.  
 
  
==External Links==
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Use of condoms to protect against the spread of STDs and AIDS. Volunteers must use condoms in every sexual encounter where bodily fluids may be transferred, or they risk contracting deadly disease. Condoms will be provided by the medical officer.
[http://www.peacecorps.gov/multimedia/pdf/policies/peacecorps_cbj_2008.pdf Congressional Budget Justification 2008] Peace Corps website (PDF, 47MB)
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Abstinence is the only certain choice for prevention of HIV/ AIDS and other STDs. You are taking risks if you choose to be sexually active. To lessen the risk, use a condom every time you have sex. Whether your partner is a host country citizen, a fellow Volunteer, or anyone else, do not assume this person is free of HIV/AIDS or other STDs.
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It is important to emphasize that while AIDS in the United States has occurred primarily (though not exclusively) in high-risk groups, in parts of the developing world, the disease affects men and women equally, regardless of sexual preference. AIDS is a sexually transmitted disease and concerns all sexually active individuals, both homosexual and heterosexual. The keys to reducing the risk of exposure to HIV/AIDS are knowledge and prevention. All Volunteers must be aware of the following basic facts:
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 +
* AIDS is a fatal viral disease that cannot now be cured.
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* The AIDS virus is spread by sexual intercourse, by contaminated blood, and by contaminated hypodermic needles.
 +
* A person can look and feel healthy and still be able to spread the virus that causes AIDS.
 +
* An infected woman can give AIDS to her child during pregnancy or during birth.
 +
* AIDS has not been shown to be spread by casual contact, such as living in the same house or sharing eating utensils.
 +
* AIDS has not been shown to be transmitted by biting insects.
 +
* Celibacy or a stable, monogamous relationship with another uninfected person is the safest way to avoid infection. In any case, reducing the number of sexual partners reduces the chances of getting AIDS.
 +
* Use of condoms reduces the exchange of body fluids and may reduce the risk of AIDS infection during sexual contact.
 +
 
 +
Your Peace Corps medical officer will provide you with more specific information in-country and will keep you informed of measures you can take to reduce your risk of exposure, including:
 +
 
 +
* Abstinence from sexual contact, limiting the number of your sexual partners, and avoiding sexual contact with someone who has had many sexual partners.
 +
* Consistent and correct use of condoms with every act of intercourse. Protect yourself, and protect your partner.
 +
* Avoid any injections not being provided by your Peace Corps medical officer.
 +
* Avoid giving or receiving a blood transfusion except under the supervision of the Peace Corps medical officer, or in cases of life-threatening injury or illness.
 +
* Avoid sharing toothbrushes and razors (which may be contaminated with blood).
 +
* Avoid all practices that result in penetration of skin surfaces (such as acupuncture, ear-piercing, tattooing, blood-brotherhood ceremonies, or other incisions of the skin during traditional ceremonial or healing practices).
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 +
===Women’s Health Information===
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Volunteers are expected to adhere to an effective means of birth control to prevent unplanned pregnancies. Your medical officer can help you decide on the most appropriate method to suit your individual needs. Contraceptive methods are available without charge from the medical officer.
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 +
Pregnancy is a health condition that is treated in the same manner as other Volunteer health conditions requiring medical attention, but may also have programmatic ramifications.  The Peace Corps is responsible for determining the medical risk and the availability of appropriate medical care if the Volunteer remains in-country. Given the circumstances under which Volunteers live and work in Peace Corps countries, it is rare that the Peace Corps medical and programmatic standards for continued service can be met. The majority of Volunteers who become pregnant are medically separated.
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 +
Feminine hygiene products are not provided to you by the Peace Corps medical officer in El Salvador. These products can be purchased in El Salvador, but they are expensive.  Some Volunteers opt to bring a supply with them to El Salvador.
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 +
===Your Peace Corps Medical Kit ===
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 +
The Peace Corps medical officer provides Volunteers with a first-aid kit that contains basic items necessary to prevent and treat illnesses that might occur during service. Kit items can be periodically restocked at your Peace Corps medical office.
 +
 
 +
====Medical Kit Contents ====
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 +
Ace bandage <br>
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Adhesive tape  <br>
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Antacid tablets (Tums)  <br>
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Antiseptic antimicrobial skin cleaner (Hibiclens)  <br>
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Bacitracin/Neomycin/Polymycin B ointment  <br>
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Band-aids  <br>
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Butterfly closures  <br>
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Calamine lotion  <br>
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Cepacol lozenges  <br>
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Condoms  <br>
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Dental floss  <br>
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Diphenhydramine HCL (Benadryl): 25&nbsp;mg tablets  <br>
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Insect repellant stick (Cutter’s)  <br>
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Iodine tablets (Water purification tablets)  <br>
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Lip balm (Chapstick)  <br>
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Oral rehydration salts and Gatorade  <br>
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Oral thermometer (Fahrenheit)  <br>
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Pseudephedrine HCL (Sudafed): 30&nbsp;mg tablets  <br>
 +
Red Cross First Aid and Personal Safety Handbook  <br>
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Robitussin-DM lozenges (Cough calmers)  <br>
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Scissors  <br>
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Sterile gauze pads  <br>
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Tetrahydrozaline eye drops (Visine)  <br>
 +
Tinactin cream (Tolnaftate)  <br>
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Tweezers  <br>
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 +
 +
===Before You Leave: A Medical Checklist ===
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 +
If there has been any change in your health—physical, mental, or dental—since the time you submitted your examination reports to the Peace Corps, you must immediately notify the Office of Medical Services. Failure to disclose new illnesses, injuries, allergies, or pregnancy can endanger your health and may jeopardize your eligibility to serve.
 +
 
 +
If your dental exam was done more than a year ago, or if your physical exam is more than two years old, contact the Office of Medical Services to find out whether you need to update your records.
 +
 
 +
If your dentist or Peace Corps dental consultant has recommended that you undergo dental treatment or repair, you must complete that work and make sure your dentist sends requested confirmation reports or X-rays to the Office of Medical Services.
 +
 
 +
If you wish to avoid taking duplicate vaccinations, you should contact your physician’s office, obtain a copy of your immunization record, and bring it to your pre-departure orientation. If you have any immunizations prior to Peace Corps service, the Peace Corps cannot reimburse you for the cost. The Peace Corps will provide all the immunizations necessary for your overseas assignment shortly after you arrive in El Salvador. You do not need to begin taking malaria medication prior to departure.
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 +
Bring a three-month supply of any prescription or over-thecounter medication you use on a regular basis, including birth control pills. Although the Peace Corps cannot reimburse you for this three-month supply, we will order refills during your service.
 +
 
 +
While awaiting shipment—which can take several months— you will be dependent on your own medication supply.  The Peace Corps will not pay for herbal or non-prescribed medications, such as St. John’s Wort, glucosamine, Selenium, or anti-oxidant supplements.
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 +
You are encouraged to bring copies of medical prescriptions signed by your physician. This is not a requirement, although it might come in handy if you are questioned in transit about your on-hand three-month supply of prescription drugs.
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 +
If you wear eyeglasses, bring two pairs with you: a pair and a spare. If a pair breaks, the Peace Corps will replace it, using the information your doctor in the United States provided on the eyeglasses form during your examination. To reduce the risk of developing a serious infection or other eye disease, we discourage you from using contact lenses during your Peace Corps service. Most Peace Corps countries do not have appropriate water and sanitation to support eye care with the use of contact lenses. The Peace Corps will not supply or replace contact lenses or associated solutions unless their use has been recommended by an ophthalmologist for a specific medical condition and the Peace Corps’ Office of Medical Services has given approval.
 +
 
 +
If you are eligible for Medicare, over 50 years of age, or have a health condition that may restrict your future participation in healthcare plans, you may wish to consult an insurance specialist about unique coverage needs before your departure.
 +
 
 +
The Peace Corps will provide all necessary healthcare from the time you leave for your pre-departure orientation until you complete your service. When you finish, you will be entitled to the post-service healthcare benefits as described in the Peace Corps Volunteer Handbook. You may wish to consider keeping an existing health plan in effect during your service if you think age and/or pre-existing conditions might prevent you from re-enrolling in your current plan when you return home.
 +
 
 +
===Safety and Security—Our Partnership ===
 +
 
 +
Serving as a Volunteer overseas entails certain safety and security risks. Living and traveling in an unfamiliar environment, a limited understanding of the local language and culture, and the perception of being a wealthy American are some of the factors that can put a Volunteer at risk.  Property thefts and burglaries are not uncommon. Incidents of physical and sexual assault do occur, although almost all Volunteers complete their two years of service without serious personal safety problems. In addition, more than 84 percent of Volunteers surveyed in the 2004 Peace Corps Volunteer Survey say they would join the Peace Corps again.
 +
 
 +
The Peace Corps approaches safety and security as a partnership with you. This Welcome Book contains sections on: Living Conditions and Volunteer Lifestyle; Peace Corps Training; and Your Health Care and Safety. All of these sections include important safety and security information.
 +
 
 +
The Peace Corps makes every effort to give Volunteers the tools they need to function in the safest and most secure way possible, because working to maximize the safety and security of Volunteers is our highest priority. Not only do we provide you with training and tools to prepare for the unexpected, but we teach you to identify and manage the risks you may encounter.
 +
 
 +
===Factors that Contribute to Volunteer Risk ===
 +
 
 +
There are several factors that can heighten a Volunteer’s risk, many of which are within the Volunteer’s control.
 +
 
 +
Based on information gathered from incident reports worldwide in 2004, the following factors stand out as risk characteristics for assaults. Assaults consist of personal crimes committed against Volunteers, and do not include property crimes (such as vandalism or theft).
 +
 
 +
* Location: Most crimes occurred when Volunteers were in public areas (e.g., street, park, beach, public buildings). Specifically, 43 percent of assaults took place when Volunteers were away from their sites.
 +
* Time of day: Assaults usually took place on the weekend during the evening between 5:00 p.m. and 2:00 a.m.— with most assaults occurring around 1:00 a.m.
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* Absence of others: Assaults ususally occurred when the Volunteer was unaccompanied. In 82 percent of the sexual assaults the Volunteer was unaccompannied and in 55 percent of physical assaults the Volunteer was unaccompanied.
 +
* Relationship to assailant: In most assaults, the Volunteer did not know the assailant.
 +
* Consumption of alcohol: Forty percent of all assaults involved alcohol consumption by Volunteers and/or assailants.
 +
 
 +
===Summary Strategies to Reduce Risk ===
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 +
 
 +
Before and during service, your training will address these areas of concern so that you can reduce the risks you face.
 +
 
 +
For example, here are some strategies Volunteers employ:
 +
 
 +
Strategies to reduce the risk/impact of theft:
 +
 
 +
* Know the environment and choose safe routes/times for travel 
 +
* Avoid high-crime areas per Peace Corps guidance
 +
* Know the vocabulary to get help in an emergency
 +
* Carry valuables in different pockets/places
 +
* Carry a “dummy” wallet as a decoy Strategies to reduce the risk/impact of burglary:
 +
* Live with a local family or on a family compound
 +
* Put strong locks on doors and keep valuables in a lock box or trunk
 +
* Leave irreplaceable objects at home in the U.S.
 +
* Follow Peace Corps guidelines on maintaining home security Strategies to reduce the risk/impact of assault:
 +
* Make local friends
 +
* Make sure your appearance is respectful of local customs; don’t draw negative attention to yourself by wearing inappropriate clothing
 +
* Get to know local officials, police, and neighbors
 +
* Travel with someone whenever possible
 +
* Avoid known high crime areas
 +
* Limit alcohol consumption
 +
 
 +
===Support from Staff ===
 +
 
 +
In March 2003, the Peace Corps created the Office of Safety and Security with its mission to “foster improved communication, coordination, oversight, and accountability of all Peace Corps’ safety and security efforts.” The new office is led by an Associate Director for Safety and Security who reports to the Peace Corps Director and includes the following divisions: Volunteer Safety and Overseas Security; Information and Personnel Security; Emergency Preparedness, Plans, Training and Exercise; and Crime Statistics and Analysis.
 +
 
 +
The major responsibilities of the Volunteer Safety and Overseas Security Division are to coordinate the office’s overseas operations and direct the Peace Corps’ safety and security officers who are located in various regions around the world that have Peace Corps programs. The safety and security officers conduct security assessments; review safety trainings; train trainers and managers; train Volunteer safety wardens, local guards, and staff; develop security incident response procedures; and provide crisis management support.
 +
 
 +
If a trainee or Volunteer is the victim of a safety incident, Peace Corps staff is prepared to provide support. All Peace Corps posts have procedures in place to respond to incidents of crime committed against Volunteers. The first priority for all posts in the aftermath of an incident is to ensure that the Volunteer is safe and receiving medical treatment as needed.  After assuring the safety of the Volunteer, Peace Corps staff provide support by reassessing the Volunteer’s work site and housing arrangements and making any adjustments, as needed. In some cases, the nature of the incident may necessitate a site or housing transfer. Peace Corps staff will also assist Volunteers with preserving their rights to pursue legal sanctions against the perpetrators of the crime. It is very important that Volunteers report incidents as they occur, not only to protect their peer Volunteers, but also to preserve the future right to prosecute. Should Volunteers decide later in the process that they want to proceed with the prosecution of their assailant, this option may no longer exist if the evidence of the event has not been preserved at the time of the incident.
 +
 
 +
The country-specific data chart below shows the incidence rates and the average number of incidents of the major types of safety incidents reported by Peace Corps Volunteers/ trainees in El Salvador as compared to all other Inter-America and Pacific region programs as a whole, from 2000–2004.  It is presented to you in a somewhat technical manner for statistical accuracy.
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To fully appreciate the collected data below, an explanation of the graph is provided as follows:  
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The incidence rate for each type of crime is the number of crime events relative to the Volunteer/trainee population.  It is expressed on the chart as a ratio of crime to Volunteer and trainee years (or V/T years, which is a measure of 12 full months of V/T service) to allow for a statistically valid way to compare crime data across countries. An “incident” is a specific offense, per Peace Corps' classification of offenses, and may involve one or more Volunteer/trainee victims. For example, if two Volunteers are robbed at the same time and place, this is classified as one robbery incident.
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The chart is separated into eight crime categories. These include vandalism (malicious defacement or damage of property); theft (taking without force or illegal entry); burglary (forcible entry of a residence); robbery (taking something by force); minor physical assault (attacking without a weapon with minor injuries); minor sexual assault (fondling, groping, etc.); aggravated assault (attacking with a weapon, and/or without a weapon when serious injury results); and rape (sexual intercourse without consent).  
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When anticipating Peace Corps Volunteer service, you should review all of the safety and security information provided to you, including the strategies to reduce risk. Throughout your training and Volunteer service, you will be expected to successfully complete all training competencies in a variety of areas including safety and security. Once in-country, use the tools and information shared with you to remain as safe and secure as possible.
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===What If You Become a Victim of a Violent Hate Crime? ===
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Few Peace Corps Volunteers are victims of violent crimes. The Peace Corps will give you information and training in how to be safe. But, just as in the U.S., crime happens, and Volunteers can become victims. When this happens, the investigative team of the Office of Inspector General (OIG) is charged with helping pursue prosecution of those who perpetrate a violent crime against a Volunteer. If you become a victim of a violent crime, the decision to prosecute or not to prosecute is entirely yours, and one of the tasks of the OIG is to make sure that you are fully informed of your options and help you through the process and procedures involved in going forward with prosecution should you wish to do so.  If you decide to prosecute, we are here to assist you in every way we can.
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Crimes that occur overseas, of course, are investigated and prosecuted by local authorities in local courts. Our role is to coordinate the investigation and evidence collection with the regional security officers (RSOs) at the U.S. embassy, local police, and local prosecutors and others to ensure that your rights are protected to the fullest extent possible under the laws of the country. OIG investigative staff has extensive experience in criminal investigation, in working sensitively with victims, and as advocates for victims. We also, may, in certain limited circumstances, arrange for the retention of a local lawyer to assist the local public prosecutor in making the case against the individual who perpetrated the violent crime.
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If you do become a victim of a violent crime, first, make sure you are in a safe place and with people you trust and second, contact the country director or the Peace Corps medical officer. Immediate reporting is important to the preservation of evidence and the chances of apprehending the suspect.  Country directors and medical officers are required to report all violent crimes to the Inspector General and the RSO. This information is protected from unauthorized further disclosure by the Privacy Act. Reporting the crime also helps prevent your further victimization and protects your fellow Volunteers.
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In conjunction with the RSO, the OIG does a preliminary investigation of all violent crimes against Volunteers regardless of whether the crime has been reported to local authorities or of the decision you may ultimately make to prosecute. If you are a victim of a crime, our staff will work with you through final disposition of the case. OIG staff is available 24 hours-a-day, 7 days-a-week. We may be contacted through our 24-hour violent crime hotline via telephone at 202.692.2911, or by e-mail at violentcrimehotline@peacecorps.gov.
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===Security Issues in El Salvador ===
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When it comes to your safety and security in the Peace Corps, you have to be willing to adapt your behavior and lifestyle to minimize the potential for being a target of crime. As with anywhere in the world, crime does exist in El Salvador.  You can reduce your risk of becoming a target for crime by avoiding situations that make you feel uncomfortable and by taking advance precautions. Crime at the village or town level is less frequent than in the large cities, where people know each other and generally will not steal from their neighbors.  Tourist attractions, especially in large towns, are the favorite work sites for pickpockets.
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===Staying Safe: Don’t Die or Sue us! ===
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You must be prepared to take on a large responsibility for your own safety. Only you can make yourself less of a target, ensure that your house is secure, and develop relations in your community that will make you an unlikely victim of crime. In coming to El Salvador, do what you would do if you moved to a large city in the United States: be cautious, check things out, ask questions, learn about your neighborhood, know where the more risky locations are, use common sense, and be aware. You can reduce your vulnerability to crime by integrating into your community, learning the local language, acting responsibly, and abiding by Peace Corps policies and procedures. Serving safely and effectively in El Salvador may require that you accept some restrictions to your current lifestyle.
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Volunteers attract a lot of attention in large cities and their sites, they but receive far more negative attention in highly populated centers where they are anonymous. In smaller towns, “family,” friends, and colleagues look out for them. While whistles and exclamations are fairly common on the street, this behavior can be reduced if you dress conservatively, avoid eye contact, and do not respond to such negative and unwanted attention. Other methods have helped Volunteers avoid becoming targets of unwanted attention and crime. Keep your money out of sight—use an undergarment money pouch, such as the kind that hangs around your neck and stays hidden under your shirt or inside your coat. Do not keep your money in outside pockets of backpacks, in coat pockets, or in fanny packs. You should always walk at night with a companion.
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===Physical and Sexual Assault ===
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In El Salvador, Volunteers may be impacted by incidents of theft due to the current economic situation and impacts of the post-conflict era. As a Volunteer, you have to be willing to forego certain freedoms that you may take for granted; freedoms like going to a deserted beach or forest, going out alone at night, or walking alone on some roads. You must take precautions that you may not be accustomed to taking in your hometown or city. And even if you take those precautions, you may be a victim simply because somebody wants something and they think they can get it from you—items such as money, electronics, jewelry, a bicycle, camera, appliance, or clothes.
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People react differently to the threat of crime. The challenge of each Volunteer is to identify what threats are real and then to develop strategies to minimize the risks so that they can concentrate on the work that they came to do. The Peace Corps will help you understand the risks and how to live safely, but personal safety is the responsibility of each individual. Building your own safety net and habits is an important part of integrating into any culture. Choosing the right friends, dressing appropriately, concealing valuable items, living in a safe neighborhood where you interact with your neighbors, staying away from isolated places, using safe transportation at night, and locking your doors are all precautions that you must take to enhance your personal safety as a Volunteer.
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It is possible that during your Peace Corps service you may become a victim of physical or sexual assault. It happens in the Peace Corps world, as it does in the United States.  More than 40 years of Peace Corps experience worldwide indicates that, just as in the United States, you can help avoid or reduce some of the risk by being sensitive to your surroundings, culture, and environment; by modifying some habits or behavior; and by using common sense. You will receive a thorough briefing on how to minimize risk in El Salvador. Should you become a victim of violence, the medical office is there to help you, and the medical unit will keep your information confidential. Should you become a victim of assault or other violence, it is imperative that you inform the Peace Corps medical office and receive appropriate care, including care for your emotional well-being.
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Crime is a problem throughout the world, and it is a concern in El Salvador. Peace Corps/El Salvador has also taken steps to help Volunteers lessen their risk of being victims of crime and has put in place safety criteria for site placement and housing, made programming changes, and continuously improved safety and security training during pre-service training and throughout the two-year period of Volunteer service. Peace Corps/El Salvador has also increased Volunteer preparedness as Volunteers pass their awareness, knowledge, and history on to succeeding groups of Volunteers.
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Preparing for the Unexpected: Safety Training and Volunteer
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===Support in El Salvador ===
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The Peace Corps’ approach to safety is a five-pronged plan to help you stay safe during your two-year service and includes the following: information sharing; Volunteer training; site selection criteria; a detailed emergency action plan; and protocols for addressing safety and security incidents. El Salvador’s in-country safety program is outlined below.
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Information sharing can take many forms, but essentially this means that the Peace Corps/El Salvador office will keep Volunteers informed of any issues that may impact Volunteer safety. Regular updates will be offered in Volunteer newsletters and in memoranda from the country director.  Similarly, Peace Corps/El Salvador also asks that Volunteers keep the staff informed of any changes or developments in the safety and security climate of their site or region. In the event of a critical situation or emergency, Volunteers will be contacted through the emergency communication network.
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Volunteer training will include sessions to prepare you for specific safety and security issues in El Salvador. This training will prepare you to adopt a culturally appropriate lifestyle and to exercise judgment that promotes safety and reduces risk in your home, at work, and while traveling. Safety training is offered throughout your two-year service and is integrated into the language, cross-cultural, health, and other components of training.
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Certain site selection criteria are used to determine safe housing for Volunteers before their arrival. Peace Corps staff works closely with host communities and counterpart agencies to help prepare them for the Volunteer’s arrival and to establish expectations of their respective role in supporting the Volunteer. Each site is inspected before the Volunteer’s arrival to ensure assignment to an appropriate, safe, and secure housing and work site. Site selection criteria are based, in part, on any relevant site history; access to medical, banking, postal, and other essential services; availability of communications, transportation, and markets; different housing options and living arrangements; and other support needs.
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You will also learn about the country’s detailed emergency action plan, which exists in case of civil or political unrest or a natural disaster. When you arrive at your site, you will complete and submit a site locator form with your address, contact information, and a map to your house. If there is a security threat, Volunteers in El Salvador will gather at predetermined locations until the situation resolves itself or the Peace Corps decides to evacuate.
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Finally, in order to be fully responsive to the needs of Volunteers, it is imperative that Volunteers immediately report any security incident to the Peace Corps medical officer. The Peace Corps has established protocols for addressing safety and security incidents in a timely and appropriate manner.  In addition to responding to the needs of the Volunteer, the Peace Corps collects and evaluates safety and security data to track trends and develop strategies to minimize risks to future Volunteers.
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[[Category:El Salvador]]
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[[Category:Health and Safety]]

Revision as of 00:47, 13 March 2009


Health care and safety in [[{{#explode:Health care and safety in El Salvador| |5}} {{#explode:Health care and safety in El Salvador| |6}} {{#explode:Health care and safety in El Salvador| |7}}]]
The Peace Corps’ highest priority is maintaining the good health and safety of every Volunteer and trainee. Medical programs emphasize the preventive, rather than the curative approach to disease.

Serving as a Volunteer overseas entails certain safety and security risks. Living and traveling in an unfamiliar environment, a limited understanding of the local language and culture, and the perception of being a wealthy American are some of the factors that can put a Volunteer at risk.

  • [[Packing list for {{#explode:Health care and safety in El Salvador| |5}} {{#explode:Health care and safety in El Salvador| |6}} {{#explode:Health care and safety in El Salvador| |7}}]]
  • [[Training in {{#explode:Health care and safety in El Salvador| |5}} {{#explode:Health care and safety in El Salvador| |6}} {{#explode:Health care and safety in El Salvador| |7}}]]
  • [[Living conditions and volunteer lifestyles in {{#explode:Health care and safety in El Salvador| |5}} {{#explode:Health care and safety in El Salvador| |6}} {{#explode:Health care and safety in El Salvador| |7}}]]
  • [[Health care and safety in {{#explode:Health care and safety in El Salvador| |5}} {{#explode:Health care and safety in El Salvador| |6}} {{#explode:Health care and safety in El Salvador| |7}}]]
  • [[Diversity and cross-cultural issues in {{#explode:Health care and safety in El Salvador| |5}} {{#explode:Health care and safety in El Salvador| |6}} {{#explode:Health care and safety in El Salvador| |7}}]]
  • [[FAQs about Peace Corps in {{#explode:Health care and safety in El Salvador| |5}} {{#explode:Health care and safety in El Salvador| |6}} {{#explode:Health care and safety in El Salvador| |7}}]]
  • [[History of the Peace Corps in {{#explode:Health care and safety in El Salvador| |5}} {{#explode:Health care and safety in El Salvador| |6}} {{#explode:Health care and safety in El Salvador| |7}}]]
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See also:
Pre-Departure Checklist
Staging Timeline
The Health of the Volunteer The Safety of the Volunteer


The Peace Corps’ highest priority is maintaining the good health and safety of every Volunteer. Peace Corps medical programs emphasize the preventive, rather than the curative, approach to disease. As a rule of thumb, good healthcare comes from good health maintenance. The Peace Corps in El Salvador maintains a full-time medical officer who takes care of Volunteers’ primary healthcare needs. Medical services, such as testing and basic treatment, are also available in El Salvador at local, American-standard hospitals. If you become seriously ill, you will be transported to either a medical facility in the region or to the United States.

Health Issues in El Salvador

Major health problems among Peace Corps Volunteers in El Salvador are rare and are often the result of a Volunteer not taking preventive measures to stay healthy. The most common health problems are mostly minor ones that are also found in the United States, such as colds, diarrhea, hemorrhoids, constipation, sinus infections, skin infections, headaches, ear infections, dental problems, minor injuries, sexually transmitted diseases (STDs), adjustment disorders, emotional problems, and alcohol abuse. These problems may be more frequent or compounded by life in El Salvador, because certain environmental factors here raise the risk and/or exacerbate the severity of illness and injuries.

The most common major health concerns in El Salvador are malaria, rabies, tuberculosis, dengue fever, typhoid, intestinal parasites, upper respiratory infections, hepatitis, and HIV/ AIDS. Because malaria is endemic in El Salvador, anti-malarial medication (aralen)is required. You will also be vaccinated against hepatitis A and B, typhoid, rabies, tuberculosis, and diptheria. Many of these health concerns can be easily avoided by using common sense and following basic preventive practices.

Helping You Stay Healthy

The Peace Corps will provide you with all the necessary inoculations, medications, and information you need to stay healthy; however, you must accept responsibility for the appropriate use of the information and medication provided. Upon your arrival in El Salvador, you will receive a medical handbook. At the end of training, you will receive a first-aid kit with supplies to take care of mild illnesses and first-aid needs.

During training, you will have access to basic first aid supplies through the Peace Corps medical officer. However, you will be responsible for your own supply of prescription drugs and any other specific medical supplies you require, as we will not order these items during training. Please bring a three-month supply of any prescription drugs you use since they may not be available here and it may take several months for new shipments to arrive.

You will have physical examinations at mid-service and at the end of your service. If you develop a serious medical problem during your service, the medical officer in El Salvador will consult with the Office of Medical Services in Washington, D.C. If it is determined that your condition cannot be treated in El Salvador, you may be sent out of the country for further evaluation and care.

Maintaining Your Health

As Peace Corps Volunteers, you must accept a certain amount of responsibility for your own health. Proper precautions, if taken, will significantly reduce your risk of contracting serious illness and sustaining serious injury. The old adage, “An ounce of prevention …” becomes extremely important in areas where medical diagnostic and treatment facilities are not up to standards of the United States.

It is critical to your health that you promptly report to the medical office or other designated facility for scheduled immunizations, and that you let your medical officer know immediately of significant illness and injuries.

The most important of your responsibilities include:

Adherence to recommended standards for food and water preparation. Many diseases that afflict Volunteers worldwide are entirely preventable if proper food and water precautions are taken. These diseases include food poisoning, amebiasis, giardiasis, hepatitis A, dysentery, worms, tapeworms, cholera, and typhoid fever. Your medical officer will discuss specific standards for water and food preparation for El Salvador during pre-service training.

Strict adherence to recommended drug regimen for the prevention of malaria. Malaria is endemic in most areas of the Peace Corps world. For all Volunteers serving in malaria endemic areas, or for those traveling in malaria endemic areas, it is extremely important to fully comply with the recommended drug regimen to prevent malaria. Malaria can be rapidly fatal in people who have no natural immunity to the disease. Peace Corps Volunteers who do not fully comply with the required preventive regimen may be administratively separated. Your medical officer will discuss specific recommendations for the prevention of malaria in your area.

Prompt reporting to the medical office of any possible exposure to rabies. Rabies is present in nearly all Peace Corps countries. Any possible exposure to a rabid animal must be reported immediately to the medical office. Rabies exposure can occur through animal bites, scratches from animals’ teeth, and contact with animal saliva. Your medial officer will take into consideration many factors to decide the appropriate course of therapy necessary to prevent rabies. Rabies, if contracted, is 100 percent fatal. All necessary rabies immunizations will be given by the Peace Corps medical office and only the Peace Corps medical office.

Use of an effective means of birth control. Volunteers are expected to adhere to an effective means of birth control to prevent unwanted pregnancies. Your medical officer can help you decide on the most appropriate method to suit your individual needs. Contraceptive methods are available without charge from the Peace Corps medical office.

Use of condoms to protect against the spread of STDs and AIDS. Volunteers must use condoms in every sexual encounter where bodily fluids may be transferred, or they risk contracting deadly disease. Condoms will be provided by the medical officer.

Abstinence is the only certain choice for prevention of HIV/ AIDS and other STDs. You are taking risks if you choose to be sexually active. To lessen the risk, use a condom every time you have sex. Whether your partner is a host country citizen, a fellow Volunteer, or anyone else, do not assume this person is free of HIV/AIDS or other STDs.

It is important to emphasize that while AIDS in the United States has occurred primarily (though not exclusively) in high-risk groups, in parts of the developing world, the disease affects men and women equally, regardless of sexual preference. AIDS is a sexually transmitted disease and concerns all sexually active individuals, both homosexual and heterosexual. The keys to reducing the risk of exposure to HIV/AIDS are knowledge and prevention. All Volunteers must be aware of the following basic facts:

  • AIDS is a fatal viral disease that cannot now be cured.
  • The AIDS virus is spread by sexual intercourse, by contaminated blood, and by contaminated hypodermic needles.
  • A person can look and feel healthy and still be able to spread the virus that causes AIDS.
  • An infected woman can give AIDS to her child during pregnancy or during birth.
  • AIDS has not been shown to be spread by casual contact, such as living in the same house or sharing eating utensils.
  • AIDS has not been shown to be transmitted by biting insects.
  • Celibacy or a stable, monogamous relationship with another uninfected person is the safest way to avoid infection. In any case, reducing the number of sexual partners reduces the chances of getting AIDS.
  • Use of condoms reduces the exchange of body fluids and may reduce the risk of AIDS infection during sexual contact.

Your Peace Corps medical officer will provide you with more specific information in-country and will keep you informed of measures you can take to reduce your risk of exposure, including:

  • Abstinence from sexual contact, limiting the number of your sexual partners, and avoiding sexual contact with someone who has had many sexual partners.
  • Consistent and correct use of condoms with every act of intercourse. Protect yourself, and protect your partner.
  • Avoid any injections not being provided by your Peace Corps medical officer.
  • Avoid giving or receiving a blood transfusion except under the supervision of the Peace Corps medical officer, or in cases of life-threatening injury or illness.
  • Avoid sharing toothbrushes and razors (which may be contaminated with blood).
  • Avoid all practices that result in penetration of skin surfaces (such as acupuncture, ear-piercing, tattooing, blood-brotherhood ceremonies, or other incisions of the skin during traditional ceremonial or healing practices).

Women’s Health Information

Volunteers are expected to adhere to an effective means of birth control to prevent unplanned pregnancies. Your medical officer can help you decide on the most appropriate method to suit your individual needs. Contraceptive methods are available without charge from the medical officer.

Pregnancy is a health condition that is treated in the same manner as other Volunteer health conditions requiring medical attention, but may also have programmatic ramifications. The Peace Corps is responsible for determining the medical risk and the availability of appropriate medical care if the Volunteer remains in-country. Given the circumstances under which Volunteers live and work in Peace Corps countries, it is rare that the Peace Corps medical and programmatic standards for continued service can be met. The majority of Volunteers who become pregnant are medically separated.

Feminine hygiene products are not provided to you by the Peace Corps medical officer in El Salvador. These products can be purchased in El Salvador, but they are expensive. Some Volunteers opt to bring a supply with them to El Salvador.

Your Peace Corps Medical Kit

The Peace Corps medical officer provides Volunteers with a first-aid kit that contains basic items necessary to prevent and treat illnesses that might occur during service. Kit items can be periodically restocked at your Peace Corps medical office.

Medical Kit Contents

Ace bandage
Adhesive tape
Antacid tablets (Tums)
Antiseptic antimicrobial skin cleaner (Hibiclens)
Bacitracin/Neomycin/Polymycin B ointment
Band-aids
Butterfly closures
Calamine lotion
Cepacol lozenges
Condoms
Dental floss
Diphenhydramine HCL (Benadryl): 25 mg tablets
Insect repellant stick (Cutter’s)
Iodine tablets (Water purification tablets)
Lip balm (Chapstick)
Oral rehydration salts and Gatorade
Oral thermometer (Fahrenheit)
Pseudephedrine HCL (Sudafed): 30 mg tablets
Red Cross First Aid and Personal Safety Handbook
Robitussin-DM lozenges (Cough calmers)
Scissors
Sterile gauze pads
Tetrahydrozaline eye drops (Visine)
Tinactin cream (Tolnaftate)
Tweezers


Before You Leave: A Medical Checklist

If there has been any change in your health—physical, mental, or dental—since the time you submitted your examination reports to the Peace Corps, you must immediately notify the Office of Medical Services. Failure to disclose new illnesses, injuries, allergies, or pregnancy can endanger your health and may jeopardize your eligibility to serve.

If your dental exam was done more than a year ago, or if your physical exam is more than two years old, contact the Office of Medical Services to find out whether you need to update your records.

If your dentist or Peace Corps dental consultant has recommended that you undergo dental treatment or repair, you must complete that work and make sure your dentist sends requested confirmation reports or X-rays to the Office of Medical Services.

If you wish to avoid taking duplicate vaccinations, you should contact your physician’s office, obtain a copy of your immunization record, and bring it to your pre-departure orientation. If you have any immunizations prior to Peace Corps service, the Peace Corps cannot reimburse you for the cost. The Peace Corps will provide all the immunizations necessary for your overseas assignment shortly after you arrive in El Salvador. You do not need to begin taking malaria medication prior to departure.

Bring a three-month supply of any prescription or over-thecounter medication you use on a regular basis, including birth control pills. Although the Peace Corps cannot reimburse you for this three-month supply, we will order refills during your service.

While awaiting shipment—which can take several months— you will be dependent on your own medication supply. The Peace Corps will not pay for herbal or non-prescribed medications, such as St. John’s Wort, glucosamine, Selenium, or anti-oxidant supplements.

You are encouraged to bring copies of medical prescriptions signed by your physician. This is not a requirement, although it might come in handy if you are questioned in transit about your on-hand three-month supply of prescription drugs.

If you wear eyeglasses, bring two pairs with you: a pair and a spare. If a pair breaks, the Peace Corps will replace it, using the information your doctor in the United States provided on the eyeglasses form during your examination. To reduce the risk of developing a serious infection or other eye disease, we discourage you from using contact lenses during your Peace Corps service. Most Peace Corps countries do not have appropriate water and sanitation to support eye care with the use of contact lenses. The Peace Corps will not supply or replace contact lenses or associated solutions unless their use has been recommended by an ophthalmologist for a specific medical condition and the Peace Corps’ Office of Medical Services has given approval.

If you are eligible for Medicare, over 50 years of age, or have a health condition that may restrict your future participation in healthcare plans, you may wish to consult an insurance specialist about unique coverage needs before your departure.

The Peace Corps will provide all necessary healthcare from the time you leave for your pre-departure orientation until you complete your service. When you finish, you will be entitled to the post-service healthcare benefits as described in the Peace Corps Volunteer Handbook. You may wish to consider keeping an existing health plan in effect during your service if you think age and/or pre-existing conditions might prevent you from re-enrolling in your current plan when you return home.

Safety and Security—Our Partnership

Serving as a Volunteer overseas entails certain safety and security risks. Living and traveling in an unfamiliar environment, a limited understanding of the local language and culture, and the perception of being a wealthy American are some of the factors that can put a Volunteer at risk. Property thefts and burglaries are not uncommon. Incidents of physical and sexual assault do occur, although almost all Volunteers complete their two years of service without serious personal safety problems. In addition, more than 84 percent of Volunteers surveyed in the 2004 Peace Corps Volunteer Survey say they would join the Peace Corps again.

The Peace Corps approaches safety and security as a partnership with you. This Welcome Book contains sections on: Living Conditions and Volunteer Lifestyle; Peace Corps Training; and Your Health Care and Safety. All of these sections include important safety and security information.

The Peace Corps makes every effort to give Volunteers the tools they need to function in the safest and most secure way possible, because working to maximize the safety and security of Volunteers is our highest priority. Not only do we provide you with training and tools to prepare for the unexpected, but we teach you to identify and manage the risks you may encounter.

Factors that Contribute to Volunteer Risk

There are several factors that can heighten a Volunteer’s risk, many of which are within the Volunteer’s control.

Based on information gathered from incident reports worldwide in 2004, the following factors stand out as risk characteristics for assaults. Assaults consist of personal crimes committed against Volunteers, and do not include property crimes (such as vandalism or theft).

  • Location: Most crimes occurred when Volunteers were in public areas (e.g., street, park, beach, public buildings). Specifically, 43 percent of assaults took place when Volunteers were away from their sites.
  • Time of day: Assaults usually took place on the weekend during the evening between 5:00 p.m. and 2:00 a.m.— with most assaults occurring around 1:00 a.m.
  • Absence of others: Assaults ususally occurred when the Volunteer was unaccompanied. In 82 percent of the sexual assaults the Volunteer was unaccompannied and in 55 percent of physical assaults the Volunteer was unaccompanied.
  • Relationship to assailant: In most assaults, the Volunteer did not know the assailant.
  • Consumption of alcohol: Forty percent of all assaults involved alcohol consumption by Volunteers and/or assailants.

Summary Strategies to Reduce Risk

Before and during service, your training will address these areas of concern so that you can reduce the risks you face.

For example, here are some strategies Volunteers employ:

Strategies to reduce the risk/impact of theft:

  • Know the environment and choose safe routes/times for travel
  • Avoid high-crime areas per Peace Corps guidance
  • Know the vocabulary to get help in an emergency
  • Carry valuables in different pockets/places
  • Carry a “dummy” wallet as a decoy Strategies to reduce the risk/impact of burglary:
  • Live with a local family or on a family compound
  • Put strong locks on doors and keep valuables in a lock box or trunk
  • Leave irreplaceable objects at home in the U.S.
  • Follow Peace Corps guidelines on maintaining home security Strategies to reduce the risk/impact of assault:
  • Make local friends
  • Make sure your appearance is respectful of local customs; don’t draw negative attention to yourself by wearing inappropriate clothing
  • Get to know local officials, police, and neighbors
  • Travel with someone whenever possible
  • Avoid known high crime areas
  • Limit alcohol consumption

Support from Staff

In March 2003, the Peace Corps created the Office of Safety and Security with its mission to “foster improved communication, coordination, oversight, and accountability of all Peace Corps’ safety and security efforts.” The new office is led by an Associate Director for Safety and Security who reports to the Peace Corps Director and includes the following divisions: Volunteer Safety and Overseas Security; Information and Personnel Security; Emergency Preparedness, Plans, Training and Exercise; and Crime Statistics and Analysis.

The major responsibilities of the Volunteer Safety and Overseas Security Division are to coordinate the office’s overseas operations and direct the Peace Corps’ safety and security officers who are located in various regions around the world that have Peace Corps programs. The safety and security officers conduct security assessments; review safety trainings; train trainers and managers; train Volunteer safety wardens, local guards, and staff; develop security incident response procedures; and provide crisis management support.

If a trainee or Volunteer is the victim of a safety incident, Peace Corps staff is prepared to provide support. All Peace Corps posts have procedures in place to respond to incidents of crime committed against Volunteers. The first priority for all posts in the aftermath of an incident is to ensure that the Volunteer is safe and receiving medical treatment as needed. After assuring the safety of the Volunteer, Peace Corps staff provide support by reassessing the Volunteer’s work site and housing arrangements and making any adjustments, as needed. In some cases, the nature of the incident may necessitate a site or housing transfer. Peace Corps staff will also assist Volunteers with preserving their rights to pursue legal sanctions against the perpetrators of the crime. It is very important that Volunteers report incidents as they occur, not only to protect their peer Volunteers, but also to preserve the future right to prosecute. Should Volunteers decide later in the process that they want to proceed with the prosecution of their assailant, this option may no longer exist if the evidence of the event has not been preserved at the time of the incident.

The country-specific data chart below shows the incidence rates and the average number of incidents of the major types of safety incidents reported by Peace Corps Volunteers/ trainees in El Salvador as compared to all other Inter-America and Pacific region programs as a whole, from 2000–2004. It is presented to you in a somewhat technical manner for statistical accuracy.

To fully appreciate the collected data below, an explanation of the graph is provided as follows:

The incidence rate for each type of crime is the number of crime events relative to the Volunteer/trainee population. It is expressed on the chart as a ratio of crime to Volunteer and trainee years (or V/T years, which is a measure of 12 full months of V/T service) to allow for a statistically valid way to compare crime data across countries. An “incident” is a specific offense, per Peace Corps' classification of offenses, and may involve one or more Volunteer/trainee victims. For example, if two Volunteers are robbed at the same time and place, this is classified as one robbery incident.

The chart is separated into eight crime categories. These include vandalism (malicious defacement or damage of property); theft (taking without force or illegal entry); burglary (forcible entry of a residence); robbery (taking something by force); minor physical assault (attacking without a weapon with minor injuries); minor sexual assault (fondling, groping, etc.); aggravated assault (attacking with a weapon, and/or without a weapon when serious injury results); and rape (sexual intercourse without consent).

When anticipating Peace Corps Volunteer service, you should review all of the safety and security information provided to you, including the strategies to reduce risk. Throughout your training and Volunteer service, you will be expected to successfully complete all training competencies in a variety of areas including safety and security. Once in-country, use the tools and information shared with you to remain as safe and secure as possible.

What If You Become a Victim of a Violent Hate Crime?

Few Peace Corps Volunteers are victims of violent crimes. The Peace Corps will give you information and training in how to be safe. But, just as in the U.S., crime happens, and Volunteers can become victims. When this happens, the investigative team of the Office of Inspector General (OIG) is charged with helping pursue prosecution of those who perpetrate a violent crime against a Volunteer. If you become a victim of a violent crime, the decision to prosecute or not to prosecute is entirely yours, and one of the tasks of the OIG is to make sure that you are fully informed of your options and help you through the process and procedures involved in going forward with prosecution should you wish to do so. If you decide to prosecute, we are here to assist you in every way we can.

Crimes that occur overseas, of course, are investigated and prosecuted by local authorities in local courts. Our role is to coordinate the investigation and evidence collection with the regional security officers (RSOs) at the U.S. embassy, local police, and local prosecutors and others to ensure that your rights are protected to the fullest extent possible under the laws of the country. OIG investigative staff has extensive experience in criminal investigation, in working sensitively with victims, and as advocates for victims. We also, may, in certain limited circumstances, arrange for the retention of a local lawyer to assist the local public prosecutor in making the case against the individual who perpetrated the violent crime.

If you do become a victim of a violent crime, first, make sure you are in a safe place and with people you trust and second, contact the country director or the Peace Corps medical officer. Immediate reporting is important to the preservation of evidence and the chances of apprehending the suspect. Country directors and medical officers are required to report all violent crimes to the Inspector General and the RSO. This information is protected from unauthorized further disclosure by the Privacy Act. Reporting the crime also helps prevent your further victimization and protects your fellow Volunteers.

In conjunction with the RSO, the OIG does a preliminary investigation of all violent crimes against Volunteers regardless of whether the crime has been reported to local authorities or of the decision you may ultimately make to prosecute. If you are a victim of a crime, our staff will work with you through final disposition of the case. OIG staff is available 24 hours-a-day, 7 days-a-week. We may be contacted through our 24-hour violent crime hotline via telephone at 202.692.2911, or by e-mail at violentcrimehotline@peacecorps.gov.

Security Issues in El Salvador

When it comes to your safety and security in the Peace Corps, you have to be willing to adapt your behavior and lifestyle to minimize the potential for being a target of crime. As with anywhere in the world, crime does exist in El Salvador. You can reduce your risk of becoming a target for crime by avoiding situations that make you feel uncomfortable and by taking advance precautions. Crime at the village or town level is less frequent than in the large cities, where people know each other and generally will not steal from their neighbors. Tourist attractions, especially in large towns, are the favorite work sites for pickpockets.

Staying Safe: Don’t Die or Sue us!

You must be prepared to take on a large responsibility for your own safety. Only you can make yourself less of a target, ensure that your house is secure, and develop relations in your community that will make you an unlikely victim of crime. In coming to El Salvador, do what you would do if you moved to a large city in the United States: be cautious, check things out, ask questions, learn about your neighborhood, know where the more risky locations are, use common sense, and be aware. You can reduce your vulnerability to crime by integrating into your community, learning the local language, acting responsibly, and abiding by Peace Corps policies and procedures. Serving safely and effectively in El Salvador may require that you accept some restrictions to your current lifestyle.

Volunteers attract a lot of attention in large cities and their sites, they but receive far more negative attention in highly populated centers where they are anonymous. In smaller towns, “family,” friends, and colleagues look out for them. While whistles and exclamations are fairly common on the street, this behavior can be reduced if you dress conservatively, avoid eye contact, and do not respond to such negative and unwanted attention. Other methods have helped Volunteers avoid becoming targets of unwanted attention and crime. Keep your money out of sight—use an undergarment money pouch, such as the kind that hangs around your neck and stays hidden under your shirt or inside your coat. Do not keep your money in outside pockets of backpacks, in coat pockets, or in fanny packs. You should always walk at night with a companion.

Physical and Sexual Assault

In El Salvador, Volunteers may be impacted by incidents of theft due to the current economic situation and impacts of the post-conflict era. As a Volunteer, you have to be willing to forego certain freedoms that you may take for granted; freedoms like going to a deserted beach or forest, going out alone at night, or walking alone on some roads. You must take precautions that you may not be accustomed to taking in your hometown or city. And even if you take those precautions, you may be a victim simply because somebody wants something and they think they can get it from you—items such as money, electronics, jewelry, a bicycle, camera, appliance, or clothes.

People react differently to the threat of crime. The challenge of each Volunteer is to identify what threats are real and then to develop strategies to minimize the risks so that they can concentrate on the work that they came to do. The Peace Corps will help you understand the risks and how to live safely, but personal safety is the responsibility of each individual. Building your own safety net and habits is an important part of integrating into any culture. Choosing the right friends, dressing appropriately, concealing valuable items, living in a safe neighborhood where you interact with your neighbors, staying away from isolated places, using safe transportation at night, and locking your doors are all precautions that you must take to enhance your personal safety as a Volunteer.

It is possible that during your Peace Corps service you may become a victim of physical or sexual assault. It happens in the Peace Corps world, as it does in the United States. More than 40 years of Peace Corps experience worldwide indicates that, just as in the United States, you can help avoid or reduce some of the risk by being sensitive to your surroundings, culture, and environment; by modifying some habits or behavior; and by using common sense. You will receive a thorough briefing on how to minimize risk in El Salvador. Should you become a victim of violence, the medical office is there to help you, and the medical unit will keep your information confidential. Should you become a victim of assault or other violence, it is imperative that you inform the Peace Corps medical office and receive appropriate care, including care for your emotional well-being.

Crime is a problem throughout the world, and it is a concern in El Salvador. Peace Corps/El Salvador has also taken steps to help Volunteers lessen their risk of being victims of crime and has put in place safety criteria for site placement and housing, made programming changes, and continuously improved safety and security training during pre-service training and throughout the two-year period of Volunteer service. Peace Corps/El Salvador has also increased Volunteer preparedness as Volunteers pass their awareness, knowledge, and history on to succeeding groups of Volunteers.

Preparing for the Unexpected: Safety Training and Volunteer

Support in El Salvador

The Peace Corps’ approach to safety is a five-pronged plan to help you stay safe during your two-year service and includes the following: information sharing; Volunteer training; site selection criteria; a detailed emergency action plan; and protocols for addressing safety and security incidents. El Salvador’s in-country safety program is outlined below.

Information sharing can take many forms, but essentially this means that the Peace Corps/El Salvador office will keep Volunteers informed of any issues that may impact Volunteer safety. Regular updates will be offered in Volunteer newsletters and in memoranda from the country director. Similarly, Peace Corps/El Salvador also asks that Volunteers keep the staff informed of any changes or developments in the safety and security climate of their site or region. In the event of a critical situation or emergency, Volunteers will be contacted through the emergency communication network.

Volunteer training will include sessions to prepare you for specific safety and security issues in El Salvador. This training will prepare you to adopt a culturally appropriate lifestyle and to exercise judgment that promotes safety and reduces risk in your home, at work, and while traveling. Safety training is offered throughout your two-year service and is integrated into the language, cross-cultural, health, and other components of training.

Certain site selection criteria are used to determine safe housing for Volunteers before their arrival. Peace Corps staff works closely with host communities and counterpart agencies to help prepare them for the Volunteer’s arrival and to establish expectations of their respective role in supporting the Volunteer. Each site is inspected before the Volunteer’s arrival to ensure assignment to an appropriate, safe, and secure housing and work site. Site selection criteria are based, in part, on any relevant site history; access to medical, banking, postal, and other essential services; availability of communications, transportation, and markets; different housing options and living arrangements; and other support needs.

You will also learn about the country’s detailed emergency action plan, which exists in case of civil or political unrest or a natural disaster. When you arrive at your site, you will complete and submit a site locator form with your address, contact information, and a map to your house. If there is a security threat, Volunteers in El Salvador will gather at predetermined locations until the situation resolves itself or the Peace Corps decides to evacuate.

Finally, in order to be fully responsive to the needs of Volunteers, it is imperative that Volunteers immediately report any security incident to the Peace Corps medical officer. The Peace Corps has established protocols for addressing safety and security incidents in a timely and appropriate manner. In addition to responding to the needs of the Volunteer, the Peace Corps collects and evaluates safety and security data to track trends and develop strategies to minimize risks to future Volunteers.