A U.S. Doctor Volunteers a Risky Year in a Salvadoran Rebel Zone

updated 07/18/1983 AT 01:00 AM EDT

originally published 07/18/1983 AT 01:00 AM EDT

Charlie Clements graduated from the University of Washington School of Medicine in 1980, at the age of 34, with a special prize for his "outstanding clinical competence and unusual promise as a leader of medicine." But Clements, now 37, had some unorthodox ideas on how best to use his healing talents. In March 1982 he secretly entered El Salvador to become a physician for civilians in a guerrilla-controlled zone, the Guazapa front, near San Salvador.

After a physically exhausting year behind the lines and several brushes with death, Clements returned to the U.S. last March. When he went home to the UW medical school in May to give an eyewitness account of the strife, Clements was nervous, unsure how his former professors, peers and Seattle-area physicians would react to him. But often during his 45-minute speech the applause was loud and long. "I think the university can take great pride," said Dr. Paul B. Beeson, professor emeritus of medicine. "I think it's a tremendously brave and worthwhile use of his medical background." Clements was relieved. "I was told I'd be committing professional suicide to go there," he said. "I have to be very pleased by this."

Since his homecoming, Clements has joined the national debate on El Salvador as an informed critic of U.S. policy, traveling the country, making as many as six speeches a day, and hoping to raise $250,000 for medical relief for civilians living in disputed zones. (The U.S. Defense Department is preparing to send more than 20 military doctors to work in El Salvador government facilities on a "purely humanitarian" medical mission.

Clements' dedication to the cause of El Salvador, as a medic and now as an idealistic advocate of a negotiated political settlement, is rooted in his Quaker conscience; he feels it is his moral duty to help stop the suffering, and to tell what he has seen, which he believes to be contrary to the views of U.S. policymakers. Clements says the 1,500 guerrillas he has observed were ill supplied and poorly armed, and he saw no sign of Cuban or Nicaraguan aid. Supplies were so short that he once had to perform an amputation with a Swiss Army knife and suture the wound with dental floss. Operating at the limit of his skills, he successfully removed bomb fragments from one civilian's abdomen, but had no drugs to alleviate her pain after the surgery.

"I've been called a Communist," Clements says. "I'm not. I'm a humanist and I'm involved in El Salvador because our government is responsible for much of the violence. The U.S. is sounding increasingly as it did in Vietnam 15 years ago, and I'm very aware of what that led to."

Vietnam changed his life. He was an Air Force captain flying a C-130 transport there. Clements had followed his father, a retired lieutenant colonel, into the Air Force; he graduated second in the Air Force Academy's class of 1967. The military sent him for a master's degree at the UCLA Graduate School of Management, then into pilot training. But Clements gradually began to feel that the war and his role in it were wrong. In May 1970 he told his commanding officer he didn't want to fly anymore. After vainly attempting to coax him back into the cockpit, senior officers sent him for psychiatric evaluation. Diagnosed as having "a situational reaction," Clements spent six months in a locked psychiatric ward before accepting a medical discharge. "Some psychiatrists wanted to help keep me out of prison for refusing to fly, and others thought I was crazy because I talked about secret bases in Laos and secret bombing in Cambodia," Clements recalls. "The truth is, I was right." Former Air Force lawyer Robert A. Patrick remembers his friend's distress over Vietnam: "Charlie got more and more agitated, but he didn't behave abnormally. What they did to him seemed inappropriate."

Floundering for direction, Clements wandered the globe, taking casual jobs, including a spell as an aide in a psychiatric hospital. In 1974 he was admitted to medical school. His first glimpse of the conflict in El Salvador came in 1980, when he was doing his residency in a Salinas, Calif. hospital that serves indigent migrants. "The Salvadoran refugees told me stories that made me very angry," he says. "They bore the marks of physical and psychological torture."

Clements negotiated the terms of his voluntary service with political leaders of the revolutionary coalition. He would remain neutral, would not carry a weapon, and would treat civilians in an opposition-controlled zone. All three of those agreements were tested when Clements was caught up in the coils of war. "The indiscriminate bombing day after day of civilian targets filled me with rage," he explains. "Last Oct. 18 a 500-pound bomb hit a house where I'd just been served refreshments. It killed 14 women and children in one family. They were buried alive. Sometimes I felt like taking an M-16 and shooting at the planes as you would shoot a rabid dog."

Though he claims never to have fired a weapon, Clements admits to carrying one when a guerrilla column was retreating with heavy losses. "The government was searching for us with helicopters and I had to ask myself, 'Would I use it to defend the wounded and helpless?' " At times, says Clements, he was the only physician in the area and treated everyone, civilians, guerrillas and captured government soldiers alike. He estimates that military patients amounted to only 5 percent of his caseload. Living on the standard diet of two tortillas and a handful of beans three times a day, the 5'8" Clements dropped from 160 pounds to 125. At one point he came down with dengue fever and lay delirious and dangerously ill for two weeks.

On another occasion government troops surrounded the village where Clements was running a primitive clinic. Escape was impossible in the daylight because spotter planes were circling overhead. The village defense force went out to fight while Clements frantically packed up the clinic and prepared the villagers for nighttime flight. "The gunfire was coming closer and closer and I had time to wonder, was this worthwhile? Would I do it again?" Clements felt at ease with his answer: "You don't get into something like this without realizing your demise is possible and coming to terms with it." He arranged litters for the elderly and tranquilized the children to prevent them giving away the line of villagers as they threaded through the government cordon. All escaped.

The worst risk he has run is capture by Salvadoran government troops. "There was a $5,000 reward for anyone turning in a foreigner, and government troops have a policy of routinely killing prisoners, often torturing them to death," says Clements. Of atrocities committed by the guerrillas, Clements says, "I can't deny it has happened. But it's not a systematic practice so far as I'm aware." Eyewitnesses told him that just before his arrival in El Salvador, the government forces had captured a wounded guerrilla medic and skinned him alive. "I knew that if I were captured," Clements says, "I would be killed in a fairly unpleasant manner."

Despite the pleas of his friends, Clements is considering a return to the guerrilla zones in the fall. He is now writing a book based on his El Salvador diaries and has turned down several Hollywood offers for his life story. Briefly married to a fellow student at medical school, he hopes eventually to settle down with a wife and family. "I sometimes feel I'm wandering around with half my nerve endings exposed," he concedes. "Still, I'd rather have chronic idealism than any other disease I'm familiar with."

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