By Matthew D. LaPlante
Los Angeles Daily News

Sept 12, 2015 

SAN SALVADOR — In a narrow space between rows of gleaming steel refrigerators, the dance of the dead has begun.
The slender body of a 14-year-old boy, not yet stiff with death, is dragged from the back of a coroner’s van onto a metal gurney, still wet with the fluids of its last passenger.
Medics shuffle the other body carts, left then right then left again, lifting and rolling the plastic-wrapped corpses from one gurney to another to make room for the next body.
It is early in the afternoon at the Institute of Legal Medicine in El Salvador’s volatile capital city, on what will become one of the most violent days of the most violent year in the most violent nation in the Western Hemisphere.
Not since El Salvador’s 12-year civil war, which ended in 1992, has the death toll been this high.
At least 42 people were killed on Aug. 27 in Central America’s smallest nation. That morbid mark for a day of killing thrust the number of dead above 800 in August — a record in a year in which more than 4,000 people have been killed so far.
These grim tallies are the result of a perfect storm of failed economic policies, broken truces with two Los Angeles-born gangs and a steady demand for narcotics in the United States and beyond.
Social and political scientists say the recent violence also stems from El Salvador’s civil war, which raged from 1979 to 1992 and left more than 70,000 dead. Many Savadorans fleeing the violence emigrated to Los Angeles, where they perfected street gang warfare before returning home.
In the eye of that storm are the three rows of cinder-block buildings that form this compact medical compound. Here, a wearied team of medical examiners is desperately trying not to collapse under the churn of corpses that arrive each day riddled with bullets, covered in stab wounds, or — so frequently that it no longer seems out of place — missing heads.
“Decapitations do complicate our job, because it’s quite difficult to identify a body without a head,” Dr. Yanira Silvana Martinez said. “That’s the real problem we face. It’s not just the frequency of the killings, it’s the complexity.”
When bodies arrive without heads, burnt beyond recognition or strafed by gunfire, she notes, the autopsies take a lot more time — anywhere from two hours to more than 10.
With just 15 doctors on staff to handle the corpses that come into the office nearly every hour of every day, Martinez said, “the danger is that we deal in quantity, not quality.” That, she said, leaves police and prosecutors less equipped to convict murderers, which leaves more killers on the streets, which means more deaths.
The U.S. State Department blames “inefficiency, corruption, political infighting and insufficient resources” for a criminal conviction rate that was less than 5 percent even before the recent spike in violence.
When police officers arrive at the scene of a homicide, they often find witnesses who are unwilling to talk — even if they are related to the victim. Without eyewitnesses, the medical examiners are left to piece together what happened by the injuries alone.
Like almost everyone else in the institute, Martinez is at first stoic about the damage this impossible situation is having on her own psyche. “We are professionals and this is a job that we simply must do,” she said.
But as she thumbs through a 6-inch stack of autopsy reports that she says prosecutors sometimes don’t even have time to look at, her voice breaks.
“We are working here as a maquila,” she said, using the Spanish word for sweatshop. “We are witnesses to carnage. We are overwhelmed.”

Even for people used to dealing with death, it is impossible to remain unaffected, said Dr. Alfredo Adolfo Romero Diaz. The killers, he said, seem to have gotten more and more nihilistic in recent years. “You can kill a person with only one, two or three stabs,” he said, “but we have seen corpses with hundreds of stabs wounds — not random but very meticulously placed.”
The victims often are gang members but certainly not always. Among the bodies brought in today is that of Jose Alfredo Alexander, a 45-year-old worker at a plastics factory, killed with 15 shots, most of them in the face.
“I have no clues for why he was murdered,” said Alexander’s grieving brother, Daniel Alexander. “Maybe he was mistaken for another person? He has never been in trouble. All he did was get up and go to work.”
About a third of the dead are women. Others are business owners who couldn’t or wouldn’t pay protection money to the gangs. Many are children; the doctors speak in hushed tones about a baby whose throat was slashed in front of its mother, who then was also killed — allegedly over a matter of 25 cents.
Romero sometimes looks down at the corpses before him and realizes they could be his own family members.
“I’ve changed my habits. I stay at home and won’t take my family downtown,” he said. “We’re not going paranoid. We see the reality of what is happening, and it is truly terrifying.”
The official homicide count is likely just a part of the actual death toll. Every day, from early in the morning to late in the afternoon, a parade of blank-faced Salvadorans arrives from across the country looking for family members who have gone missing — and who officials say are most likely dead.
Among the searchers is Misael Martinez, who has been looking for his brother-in-law since Aug. 3.
“We have gone repeatedly to the hospitals and to all of the morgues across the country, but we haven’t found him,” he said. “He was just a normal guy. He wasn’t in a gang. He was 42 years old and had gone to work every day for more than 20 years. Then suddenly he was gone, and we go looking each day hopeful that we will at least know his fate.”

Even back in late 2013 — when the homicide numbers fell to about seven per day across El Salvador following a government deal with gang leaders to provide better prison conditions and reduced prosecutions in exchange for fewer murders — the forensic anthropologists who work alongside the medical examiners were always busy.
For many years, they have been working to identify the remains of people buried in unmarked graves during the civil war. After the truce failed and murders began to soar in 2014, the team increasingly has been forced to turn its attention to identifying the remains of victims of the most recent violence.
On an examination table before Dr. Saul Quijada on this bloody Thursday in August is a cardboard box containing the charred bones of a young man who appears to have been recently murdered. Today’s goal, Quijada said, will be to lay out the bones in skeletal order — then try to determine whether the victim was set on fire before or after he was killed.
“Every year there are more and more victims,” Quijada said. “And every year the age is less and less. It used to be that the murder victims were 25 to 30; now the average is much lower and we are seeing children of 12, 13 and 14 years old.”
And sometimes much younger.
In a refrigerated storage facility next to his office are shelves upon shelves of cardboard boxes filled with human bones. One box contains the palm-size skull of an infant who was determined to have been strangled, along with the blue-and-green football jersey the boy was wearing when his body was found.
“You can’t do this every day and not feel the impact,” Quijada said. “Every day we are so tired.”
Dr. Jose Miguel Fortin, the director of the institute — and a practicing clinical psychiatrist — is worried for his staff members. Their exposure to such harsh violence has become their new baseline — “it is a normal thing,” he said. He frets that his employees are becoming “more aggressive” and worries that arguments, infighting and even violence might result among members of the team. Such responses, he said, are the rational psychological consequence of being exposed to such barbarity for so long.

Fortin worries about his own ability to deal with the violence, too.
“To be truthful,” the 53-year-old father of three said, “I truly am tired. I don’t think I can handle it much longer.”
But Fortin insists he isn’t angry at the gangs that have done this to him, to his people and to his country. He wants them stopped, but even as the nation’s supreme court has recently declared the gangs to be terrorists, Fortin tends to see the gangsters as victims, too.
He is not alone in that point of view. Michael Allison, a specialist in the politics of Central America at University of Scranton who was last in El Salvador in July, points out that the two largest gangs both began when Salvadoran immigrants — many of whom had been witnesses to the brutality of a war in their home country that pitted the U.S.-backed government against communist revolutionaries — arrived in Los Angeles in the 1980s.
In El Salvador, Allison notes, “many witnessed unspeakable violence … then they ended up in California, where you had a war between the Crips and the Blood going on.”
For protection, Allison said, some young Salvadorans responded by forming gangs of their own, like Mara Salvatrucha, also known as MS-13, from Pico-Union. Others integrated into fledgling multiracial gangs like 18th Street from the Rampart District.
Unlike those homegrown gangs, though, U.S. leaders had a mechanism to deal with MS-13 and 18th Street members from El Salvador. Over the next few decades many were deported back to a country still reeling from civil war, facing mounting debt and suffering from diminished foreign investment.
It is their children and grandchildren who are the gang’s newest foot soldiers.
“This has been how all these kids have learned the way,” said Dr. Marcelino Diaz Menjivar, a forensic psychologist who evaluates victims and victimizers for the court system. “At 5, 6 or 7 years old, these children want to be gang members.”
By the time the children have become adults, Fortin and Diaz both note, they have lived lives saturated by violence. It is not surprising, Fortin said, that they are violent when they grow up.
And these days, he said, it’s not just the children of gangsters who are mired in such depravity.
“We have reached a level in which the abnormal has become normal,” Fortin said. “People walk by a body and it’s a normal thing.”

On the streets of Apopa, just north of San Salvador, people hardly seem to notice as a truck, emblazoned with the skulls-and-scales logo of the medical examiner’s office, parks behind a public bus on the side of the road.
Inside the bus, a woman’s body lies in a pool of blood. It has been more than five hours since a man entered the vehicle and began shooting the woman. The coroner’s office received the call almost immediately after the shooting, but there were no trucks available — they were spread out across the city gathering other bodies.
Neighbors say the woman was the owner of a local flour mill who had been unable to pay protection money to a brutal 18th Street clique — a barrio-level gang subdivision. Even as she convulsed and slumped into her seat, witnesses say, the shooter stood in the aisle and methodically blasted away at her body.
“It was not to kill her,” said a man who lives a few doors down from the spot of this murder, which is just a few doors from where the last neighborhood killing occurred, “it was to kill the rest of us.”
The man said he will not talk to investigating officers, though he has joined a growing number of people in Apopa who have asked police to set up a substation in their neighborhood. He acknowledges, though, this might simply turn his block “into a different kind of war zone.”
The sun is setting as coroner Juan Carlos Torres Salazar arrives in Apopa. As shadows fall across the neighborhood, the masked police officers who have been on the scene since the early afternoon encourage him to hurry. It has been just a day since police and coroners were ambushed in a San Salvador neighborhood and they are eager to leave this place, where neighbors say the 18th Street gangsters have recently consolidated power after exterminating members of a rival gang called The Machine.
Torres takes his time. He is not beyond fear, he said, but these days the more gripping emotion is exhaustion.
“I’m not talking about being physically tired. Physically we can manage, but it’s the mental tiredness,” the 55-year-old coroner says. “I’m starting to feel my age now.”
Roberto Valdizon, the evening shift supervisor for the institute’s coroners, said morale in his department is very low.
“You could say, ‘I am used to it,’ but that is not true, Valdizon said. “You never get used to this. If you want to be mentally healthy, this is the worst place to be. All we see is pain, injustice, sacrifice and violence.”
When Torres’ truck arrives at the institute with the body of the woman who was killed on the bus, the medics scramble once again to clear a path in the receiving area. The gurneys are pushed this way and that. Bodies are slid into and out of refrigerators to make room. The corpses are lifted, shifted, rolled and dragged. The dance of the dead goes on.