Heart & soul
Sister Mary Annel a source of hope & health for patients in Latin America
Sister Mary V. Annel, MD ’71, MPH, dances with clowns during a Youth AIDS Theater anniversary celebration, “Delight in Life” in San Salvador.
When Susana, a Salvadoran woman living with HIV, first visited CONTRASIDA’s integrated health clinic in San Salvador, physician-founder Sister Mary V. Annel, MD ’71, MPH, asked her why she had come there when she was already enrolled in a public hospital system’s clinic.
“You people treat us differently – with respect and love,” she had said.
The sentiment echoes the values upon which Dr. Annel has lived her life and fashioned her career. For more than 30 years, she has served in Central America as a Maryknoll Sister and full-time public health missioner. For the last 17 years, she has dedicated herself to the equal and dignified care of people living with HIV/AIDS through what has become the Salvadoran Foundation for the Fight against AIDS “María Lorena,” commonly referred to as CONTRASIDA or “Against AIDS.”
Back in 1957, however, she was seeking a way to honor the faith and compassion with which she was raised while also nourishing her academic curiosities and eagerness to serve the global community. She decided to enter the Maryknoll Sisters, the first group of Catholic sisters in the United States to devote their lives to service abroad. Next year will mark the 100th year of their founding.
“When I entered Maryknoll, with the hope of later becoming a doctor, I felt that this would be a way of responding in love to what I perceived as having been blessed with the overwhelming love of God and the abundant gifts I had already received – natural gifts of intellect and personal warmth, as well as my loving family,” Dr. Annel said.
Pursuing her long-term goal, she entered medical school as one of only six women in her class, graduating from The Medical College of Wisconsin in 1971. She followed her medical education with training at University of Southern California Medical Complex and a master’s in public health and tropical disease from Tulane University. Armed with the tools and desire to serve, Dr. Annel was assigned by Maryknoll to Jacaltenango, Guatemala, where she began a 15-year mission to improve health care in that region.
Reflection on the journey
“Throughout my medical career, the theme which has persisted has been my delight in serving people, especially the poor, with my medical skills and whatever gifts I have, as well as in seeing them take charge of their own lives. When I graduated from medical school and my public health training, I was interested in integrated medical care and community health, and I knew that I didn’t want to work with people who had terminal diseases.
As I worked first in Guatemala and later in El Salvador, I found that I had a gift for medical education, as well as compassionate patient care, and that I enjoyed setting up a state-wide care system. The war in Guatemala found me training large groups of paramedics to respond to emergency needs, and facing the death of many of my young friends.
As the AIDS epidemic emerged internationally, I responded to that challenge, beginning AIDS work in El Salvador, and realizing that the war in Guatemala had prepared me to work with young people who were dying from this terrible disease. Our reality changed when the Global Fund for AIDS, tuberculosis, and malaria made it possible to have antiviral medicines available for people with AIDS, and people began living long enough to worry about getting jobs to survive.
The challenges continue as we learn more about the long-term effects of antiviral treatment and how to give integrated care, as well as finding ways to help people change their sexual conduct and their future.”
– Mary V. Annel, MD ’71, MPH
Sustainable care in Guatemala
Dr. Annel practiced in a rural, 60-bed hospital and trained more than 500 local health promoters who responded to the medical needs of their isolated communities. Some of these villages were 12 hours’ walk to the nearest bus, which took another eight to 10 hours to get to the nearest hospital.
“I found that I had a gift for teaching medicine simply to dedicated people who had not received much formal education, helping them organize their records and give quality care,” she said. “When I saw that their communities were healthier and the children better nourished, I counted that as my most significant success.”
Any success was far from easy, however. Dr. Annel was living in a war zone, and the local conflicts posed dangers and obstacles to her work for more than 10 years. The distances between the people and health care were prohibitive, as were language barriers. The official medical system in the cities was Spanish-based, but most of the indigenous population spoke a Mayan language. These tests helped guide Dr. Annel’s approach to effectively providing care.
“I believe that living and working within a centuries-old indigenous culture had the most impact on me personally, because I had to adjust my own spiritual and medical context to another cosmovision,” she said. “I learned to let walls disappear within me and to integrate prayer and action.”
AIDS research spurs mission
After the conclusion of her mission in Guatemala, Dr. Annel’s religious community drew on her public health training and experience to set a course of action for another growing ministry. In 1990, she investigated the work of missioners worldwide facing the AIDS epidemic to form recommendations for the future of Maryknoll’s international AIDS effort.
The strategy developed from her study was to focus missioners’ efforts and personnel in emerging epidemics not yet in the geometric phase of AIDS expansion. Multidisciplinary teams were consequently placed in Southeast Asia and Latin America in countries bordering AIDS epicenter countries.
The plan precipitated Dr. Annel’s return to Central America, where she established a team in El Salvador, bordering the regional AIDS epicenter of Honduras. She learned AIDS was most prevalent in the poor barrios of the capital city, San Salvador, which is where she organized what became CONTRASIDA.
Impact in El Salvador
Over the last 17 years, Dr. Annel’s work in El Salvador has concentrated on both treatment and prevention. Through 2010, she functioned as General Coordinator for the team of 22 full-time employees and 250 volunteers, as well as attending people living with HIV one day per week in the integrated health clinic. It is estimated that in El Salvador, there are between 60,000 and 80,000 people with HIV, many of whom do not know their status. Antiviral drugs are available for anyone who needs them and has the patience to wade through the overloaded public health system, but Dr. Annel said attitudes and stigma are what hinder treatment and prevention most.
CONTRASIDA provides medical care, advocacy, education, peer support, even meals and homework help. It does so with an emphasis on human dignity.
“Our AIDS Pastoral Accompaniment Program serves as a model of integrated attention for people living with the virus and their families, and we hope it challenges the public health system toward a more human alternative,” she said. “We attempt to keep people living with HIV integrated and active in their local community.
“CONTRASIDA has also had a great impact on HIV prevention, on helping young people change cultural patterns to avoid infection and on bettering gender equality.”
Some of their most effective techniques for prevention include the training of rural and urban “multiplier-teachers” to help disseminate factual information about HIV, theater presentations, and gender-based training to break cycles of prejudice, violence, fear and subjugation.
Dr. Mary Annel proudly displays her Medical College of Wisconsin diploma following her graduation in 1971.
Dr. Annel’s role with CONTRASIDA changed this spring to one of “assessor” as she turned coordination of the organization over to a Salvadoran woman in a step toward sustained local management. She said she will maintain the spirituality and historical memory for the team while also continuing to provide medical care in the clinic weekly.
Also this spring, Dr. Annel was honored with the Alumni Association’s 2011 Humanitarian Award for a lifetime of service to the underserved.
“I feel very privileged because I maintain a deep affection for the Medical College and greatly appreciate the medical education I and my classmates received,” she said. “We were well-prepared for a future of service, and from the contacts I’ve maintained over the years, I know my classmates and I have fulfilled the College’s goal of training physicians who give quality medical attention with a loving heart.”
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