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Ann Manganaro SL: Physician

Posted on June 19, 2023, by Loretto Community

I will set my hands to heal
The scorched earth; the burned and broken I will tend
Till this land shall learn some new true fire to build.

Ann Manganaro SL, physician, poet, servant of God, from her poem “January 1990”
A woman in glasses bends over a child who is laying down with a hand over his eyes.
Ann Manganaro SL, M.D., tends to a young patient in Guarjila, El Salvador, where she provided medical care to the local community and trained healthcare workers during the country’s civil war.
Photo by Mev Puleo

Ann Manganaro SL, M.D., arrived in El Salvador in 1988, living alongside the locals in a stone and mud home, providing medical care and training in the village of Guarjila and surrounding areas. She died in 1993 at age 46. A memorial stone in the chapel garden at the clinic she established expresses the community’s feelings, “Thank you for your solidarity. You will always live in our hearts.” In five years, Hermana Ana (Sister Ana), as she was known, created a living legacy in El Salvador that produces bountiful fruit to this day. Inspired by her example, an Ann Manganaro clinic and educational center for the Indigenous community is planned for Cobán, Guatemala.

by Kathleen DeSutter Jordan

When I visited my friend Ann Manganaro SL in El Salvador in 1990 in honor of her 25th anniversary as a Sister of Loretto, we spent a morning at St. Francis Church in the capital, San Salvador. Etched on the sanctuary floor, and on my heart ever since, were two Gospel-centered questions:

What does it mean to be light for the world?
What does it mean to be salt for the earth?

Ann would prove to be both.

Shortly after finishing high school at Nerinx Hall in St. Louis, Ann had entered the Sisters of Loretto. Dedicated to the founding charism of Loretto, she was committed to teaching and to community. Initially she taught at an inner-city parochial school, then at a city experimental school; in 1972 she founded and taught at the Neighborhood School in St. Louis. Ann experienced this work as very meaningful but felt drawn to living her vow of poverty more clearly and to working with the very poor in an underserved country. Having spent the summer of 1969 as a volunteer at the New York City Catholic Worker, she was profoundly influenced by the Worker’s model of Gospel living — the primacy of the spiritual; the daily practice of the works of mercy; a commitment to social justice and nonviolence; living poorly with the poor — and experienced it as “a real source of revelation and nurturance.”

A woman holds a baby in her arms and smiles.

I will try to live poorly, precariously, placing the kingdom always first, cherishing and using of the earth’s goods only what I need to sustain life simply. I will place first in my life the call to love God and to love and serve all my sisters and brothers, especially the poor and the needy. I trust that the gracious God who nourishes and sustains me in this moment will continue to touch my life, in the easy times and the hard, with grace and tenderness and mercy.’

Ann Manganaro SL, upon taking final vows as a Sister of Loretto on Dec. 28, 1976

With the support of the Loretto Community, in the fall of 1977 Ann decided to study medicine. At the same time, she was one of the founding members of Karen House, a new Catholic Worker community for women and children in St. Louis. Having completed a residency in pediatrics, and attending to personal health issues, in January 1988, Ann arrived in El Salvador to volunteer with the Jesuit Refugee Service in the midst of a ravaging civil war. She hoped to be “one countervailing force against the real evil and damage that has occurred as a result of U.S. foreign policy.” In Guarjila, a newly-settled village in the province of Chalatenango for refugees returning from Honduras, Ann lived and worked for the next five years, until her death from metastatic breast cancer on June 6, 1993.

In Guarjila, Ann’s work as a physician and a teacher reflected a fortuitous synthesis of her training and talents. Amid constant threats and the dangers of warfare — bombs, disappearances, death-squad slayings, air raids — she started a medical clinic (named Ana Manganaro Clinic after her death) that provided everyday and acute medical care. Her primary work in these years, however, was the on-going training of the village’s highly-motivated healthcare promoters (medical assistants). Focused on maternal and infant care, as well as reducing morbidity and mortality, their work was shared with international volunteers, including an American nurse, Susan Classen, who later became a Loretto co-member.

Archival photo of a woman kneeling down in a hallway with three small children around her.
In 1972 Ann founded and taught at the Neighborhood School in St. Louis. Five years later she would begin her medical studies.
Photo courtesy of Loretto Heritage Center

Now, 30 years after Ann’s death, socioeconomic changes have taken place in Guarjila, including improvements in housing, education, health services, roads and communications. While over the years these advances have been supported by intermittent government assistance, they are primarily the result of the ongoing ingenuity, resilience and hard work of the community. The Ana Manganaro Clinic is now able to offer a full range of medical and preventive services, from pediatrics and ob-gyn care to a clinical lab and pharmacy. Its staff includes a team of 44 health promoters and serves the eight municipalities of northeastern Chalatenango. Every year in Guarjila, the health team and community celebrate a Mass in honor of “Hermana Ana,” and several years ago a memorial stone was placed in the clinic’s central garden.

… there was a beautiful sunset and stars in the sky, and I was walking home after dinner to where I live alone. No more had I gotten in and settled down for the evening when combat broke out all around me. … I could hear the combat go from one side of the house to the other; I could hear the soldiers shouting in the street. … Then they started strafing with tracer bullets, which you see as little red lights crossing the sky.’

Ann Manganaro describes a battle between the guerilla army, Farabundo Martí National Liberation Front, and the Salvadoran military

Ann cherished the original name of the Sisters of Loretto, “The Little Society of the Friends of Mary under the Cross” (later shortened to Sisters of Loretto at the Foot of the Cross). She found strength and purpose in how closely her day-to-day life in El Salvador mirrored that image. Many of the poems written in her Salvadoran years reflect the profound suffering and anguish her neighbors lived with, as well as her own. Prayer, reading and writing helped Ann balance periods of discouragement and loneliness, as did the abiding care and example of the people of Guarjila and the unreserved support of the Loretto Community. Ann was particularly grateful for the time Martha Crawley CoL shared with her in El Salvador.

That image of hope which rises like light in the midst of darkness and death seems to capture the core of my life and experience here.’

Ann Manganaro, diary entry
Two women pose for a photo together sitting in front of a waterfall.
Kathleen DeSutter Jordan, pictured here with Ann Manganaro SL, met Ann when they were students at Nerinx Hall High School in St. Louis. They shared a love for Loretto and the Catholic Worker and maintained lifelong visits and correspondence.
Photo courtesy of Kathleen DeSutter Jordan

“Love is stronger than death”; the biblical exhortation from the “Song of Songs” became a sort of mantra for Salvadorans following the brutal slaughter of six Jesuits and a mother and daughter at the Central American University in San Salvador in November 1989. When a new clinic was named to honor these martyrs two years later in Guarjila, Ann wrote, “New hope does indeed spring forth here. … That image of hope which rises like light in the midst of darkness and death seems to capture the core of my life and experience here.”

Light and salt, indeed.

Author’s note: I am grateful to Dr. Dagoberto Menjivar and Gene Palumbo for current information about Guarjila.

Outside of a building with a mural of Oscar Romero and Ann Manganaro on the left and the name "'Ann Manganaro' Guarjila, Chaletenango" on the right
Clinica Ana Manganaro in Guarjila, El Salvador, as it looks today. The clinic provides medical services to eight municipalities. The healthcare program that Ann spearheaded later became part of the methodology in El Salvador’s national healthcare system. Today, however, the clinic struggles to purchase needed medicine and supplies.
Photo by Dagoberto Menjivar M.D., Guarjila, El Salvador
A woman engages with another woman carrying a full sack on her head.
Above and below, Ann Manganaro SL shares conversation with villagers. Her great love inspired love in return.
Photos by Mev Puleo
A woman holds a young girl's hand and talks with her.
Scan of handwritten poems
Two of Ann Manganaro SL’s handwritten poems on notebook paper.

“Set My Hands to Heal,” a beautiful video by friends of Ann Manganaro, is available to watch here:
To view it, you’ll need the password: IFCLA-35yrs

To help the Ann Manganaro Clinic buy medicine and other essentials, click here and select “Other ministries.” Put “Ann Manganaro” in the comments box. Or send a check with “Ann Manganaro” in the memo line to the Sisters of Loretto Finance Office, 515 Nerinx Rd., Nerinx, KY 40049.

To read all the articles in the Spring/Summer 2023 issue of Loretto Magazine, click here.

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