Oxygen is one of the simplest and most essential medical interventions available—and one of the easiest to take for granted. In U.S. hospitals and ambulances, it’s standard. But in countries like El Salvador, where many emergency vehicles lack medical oxygen equipment, it can mean the difference between life and death.

In 2023, the Salvadoran Foundation for Health and Human Development—known by its Spanish acronym, FUSAL—launched a nationwide push to strengthen the medical oxygen supply for emergency services. The organization found that many patients dependent on oxygen therapy could not be transported to their homes or other facilities due to a lack of oxygen cylinders and other equipment in emergency vehicles.

“Many ambulances in El Salvador were operating without oxygen,” said Dr. Katty Tobar de Rivas, Chief of Humanitarian Aid at FUSAL. “Some patients had to spend more time admitted in hospitals, dependent on oxygen, because there wasn’t a cylinder available to take them home.”

To help fill the gap, Direct Relief provided FUSAL with a $25,000 grant for the organization to purchase and deploy 220 refillable oxygen cylinders and tanks, 50 pressure regulators, nearly 2,000 adult masks, and 23 portable oxygen systems to the public sector and to vulnerable patients. The tanks and related respiratory therapy equipment went to 19 ambulances in the national emergency network and three emergency operations centers managed by the Salvadoran Red Cross.

“It made an immediate difference,” said Loli Sangiovanni, Director of Donor Relations at the FUSAL’s sister foundation, the Salvadoran American Humanitarian Foundation, or SAHF. “Something as simple as a tank of oxygen has had a lifesaving impact.”

Some portable systems are being loaned to patients on long-term oxygen therapy for use at home. This critical intervention is essential for those with chronic pulmonary obstructive disease, lung cancer, and other respiratory illnesses.

“In 2022, we only had three oxygen concentrators, but thanks to the donation, we are now able to support more patients,” said Audy Echeverria, Coordinator and Therapist for the Salvadoran Red Cross’s Home Continuous Oxygen Program.

Among the many patients benefiting from the equipment is Graciela Pérez de Sirbrián, who has relied on oxygen for 12 years. “Whenever I go out, I have to use a cylinder to attend a medical appointment,” said Graciela. Thanks to support from FUSAL, SAHF, Direct Relief, and the Salvadoran Red Cross, she now has a portable oxygen concentrator and other necessary equipment at her home in San Juan Tepezontes.

Without projects like this, many low-income Salvadorans have no access to oxygen outside hospitals. According to a federal census in 2020, only one in four people in El Salvador were covered under some kind of health insurance. “In this country, the system sometimes provides equipment, but it’s insufficient,” Dr. Tobar de Rivas said. “People without insurance look for institutions like the Red Cross or the National Emergency System to receive the service for free, because they don’t have the purchasing power to pay for it.”

The new supplies have allowed those institutions to reach more patients and ease pressure on public hospitals. “Now they can continue their treatment at home,” Tobar de Rivas said.

According to Sangiovanni, the donation also strengthened the country’s emergency health services at large. “Thanks to this support, the response capacity for frontline organizations in El Salvador was very much improved,” she said. “It was something the country needed, and it continues to make an impact.”

FUSAL, SAHF, and Direct Relief have a long history of responding to disasters in El Salvador, dating as far back as the deadly mudslides and flooding in the country in 2011 and as recent as a similar disaster event last year. The organizations also recently collaborated on a project to strengthen El Salvador’s vaccine cold chain system.

Since 2024, Direct Relief has provided 12 shipments of urgently needed medicines and medical supplies to FUSAL totaling more than $17 million in value.