El Salvador

The homicide rate in El Salvador ─ once the world’s highest ─ is declining, but other forms of violence continue to affect the Salvadoran population. Decades of fighting between rival gangs, their clashes with security forces, and violence against people continue to have humanitarian consequences and hamper access to health care.

People are unable to move freely between neighborhoods in areas dominated by rival gangs, marginalized by the authorities, and struggle to obtain medical assistance. In some areas, dubbed ‘red zones’, health services remain suspended due to violence and threats towards health workers. Measures to curb the spread of COVID-19, such as lockdowns, exacerbated the situation in 2020.

MSF works in the capital, San Salvador, and the nearby city of Soyapango. We try to reach the people most in need through mobile clinics, community work, and mental health care.

During the year, we extended the emergency services we operate in Soyapango in partnership with the Emergency Medical System (a national ambulance service) to other stigmatized municipalities. These included Ilopango and some zones of San Martín, Tonacatepeque, and Ciudad Delgado, which are difficult for emergency services to enter because of the violence. During the year, we made more than 2,580 emergency referrals.