Erasing Evidence of Life in a Gang
Salvadoran Clinic Removes Tattoos That Can Lead to Attacks, Jail, Lost Jobs

By N.C. Aizenman
Washington Post Foreign Service
Thursday, December 7, 2006

SAN SALVADOR -- The first patient of the day was a plump 16-year-old wearing sparkly barrettes, Mary Janes-style shoes and a shy smile.

But there was nothing girlish about the tattoo that Abelina Orellana had come to get removed: a giant "18" scrawled across her back in crude, gothic numerals. The emblem signified membership in the vicious 18th Street, or Eighteen, gang that, along with rival Mara Salvatrucha, or MS-13, has terrorized communities across Central America for nearly a decade.

As long as she was marked with the symbol, Orellana's hopes of building a new life apart from the gang were slim. Employers would be fearful of hiring her. Members of MS-13 could mistake her for an active member and attack her. And police might jail her under a 2003 law that makes gang membership a crime -- with tattoos the only evidence required. Indeed, so strong is the stigma of a gang tattoo in El Salvador that some former members who can't afford professional removal have resorted to burning their skin off with battery acid or a hot iron.

This health clinic in the basement of the concrete-block San Judas Tadeu Catholic Church in northeast San Salvador offers one of the few alternatives. Olga Morales, coordinator of the clinic's Adios Tatuajes, or "Goodbye Tattoos," project, estimates that since the program began in 2002, she has helped more than 1,000 patients. At first, all were former MS-13 or Eighteen members -- including Salvadorans deported from Washington and other U.S. cities where the gangs are also active. These days, more than half of Morales's patients are people seeking to get rid of ordinary tattoos they fear could be mistaken for gang symbols.

Now Morales cast her practiced eye on Orellana's back. The challenge, she explained, would be to avoid leaving behind a scar in the same shape as the tattoo she was about to erase.

"Okay, don't worry. I have the solution," announced Morales, an anesthesiologist by training. "I'll burn some extra skin next to the top and bottom of the '1' so the scar will just look like a rectangle."

Orellana nodded her agreement. Then she climbed onto a metal table topped by a thin, plastic mattress and lay on her stomach.

Morales injected anesthetic into Orellana's back as the young woman breathed in sharply and stared through the window at the jumble of concrete and tin huts hugging the hillside below. Other than a rooster crowing loudly in the distance, the neighborhood seemed quiet and peaceful.

In fact, this working-class enclave, known as Mejicanos, is considered such a stronghold of MS-13 that cabdrivers will not bring passengers here after dark. Last year, neighborhood gang leaders accused the Goodbye Tattoos project of trying to lure away their members and threatened to shut the clinic down. At least five of Morales's patients have been shot dead -- she presumes in retaliation for trying to leave their gangs. Three weeks ago, local MS-13 leaders sent word that they wanted the clinic to start paying $400 a month in "renta," the gang's term for the protection money it charges everyone in the neighborhood, from bus drivers to pupusa vendors.

Each time, the parish priest managed to defuse the crisis by personally meeting with the gang leaders.

"But the truth is we're very vulnerable," Morales said with a nervous smile. "We have no security. We are at their mercy."

Lately, few former MS-13 members dare come for tattoo removal for fear of being recognized by someone on the street. "I would say we get one MS member for every 10 from the 18th Street gang," Morales said.

She was holding what looked like a plastic pen with a metal tip attached by a long wire to an electrocauterizing machine.

Soon the cramped treatment room was filled with the smell of singed flesh as the tool burned away the skin above the pigment in Orellana's tattoo. As each stretch of pigment was exposed, Morales would scrub it out with a wad of gauze or a metal scraper.

The clinic uses this method because it cannot afford the equipment needed for the far less invasive laser treatments that pass harmlessly through the skin to break down the pigment underneath. Even so, the project, which is partly funded by a Belgian aid group, can cover only half of the $50 it costs to remove most tattoos. Patients must pay the rest, a substantial challenge in a nation where 40 percent of the population lives on less than $2 a day.

The electrocauterizing technique also doesn't always work on gang tattoos, which are generally done by amateurs using improvised tools that can inject the ink too unevenly or deeply under the skin.

Orellana's tattoo, at least, was coming out fairly easily.

"You know, the guy who did this for you didn't do such a bad job," Morales said with a chuckle.

"I think he's dead," Orellana answered in a tiny, childish voice. "I heard they killed him in prison."

Morales's smile faded. "Imagine that," she muttered. "Was he very young?"

Although Morales's male patients tend to remain silent during treatments, the women often seem eager to open up about their past, she said afterward. Morales does not discourage them. "It seems like it's a relief, a therapy, for them to talk," she said.

Sure enough, Orellana began to pour out her story with little further prompting. She had never intended to join Eighteen, she said. But when she was 12, gang members who had a feud with her mother retaliated by kidnapping her. They forced her to undergo the initiation ritual, which included multiple rapes in addition to the tattoo, she said. Two days later, she managed to escape and flag down a police car. But because it was no longer safe for her to live in her mother's house, authorities kept her in an orphanage for nearly three years until they could track down her father, who had been in prison for murder.

Now Orellana lives with her father's relatives in a village five hours north of the capital. But the gang's shadow still trails her. She often wakes up at night shaking and sweating from a nightmare, she said. And a few months ago, she was expelled from school when administrators learned of her tattoo during a routine health exam.

"It's for that more than anything that I want to take this thing off," she said, her voice choking with emotion for the first time during her tale. "It's like a stain on me."

Morales nodded sympathetically. She was not sure how much of Orellana's account she believed, she said later. "But the rapes: I'm sure that's true," she said. "I also live in a neighborhood where the gangs are active, and that is how they do it."

More than an hour had gone by. The "1" on Orellana's back was now a mass of raw, bleeding flesh.

"Okay, kid. We've done enough for today," Morales said.

As the girl dressed in a corner, Morales peeked into the waiting area to see who was next.

Two men whose tattoos she had begun removing the week before were seated in plastic chairs, waiting patiently for their follow-up sessions. The first, a tall 31-year-old dressed in pressed pants and a button-down shirt, spoke English more fluently than Spanish. He had been deported from Los Angeles less than a month ago for reasons that he would not divulge and was getting the "Proud to be Salvadoran" tattoo around his neck removed at the panicked urging of his relatives.

The second, a sullen 17-year-old former Eighteen member, was accompanied by an older cousin who said he was there mainly to offer protection but also to make sure that the teenager went through with the removal. Although the youth defected from the gang two years ago, he had resisted erasing his tattoos until now because they reminded him of the close friendships he had made in the gang.

As she contemplated the work ahead of her, Morales suddenly looked tired. Then she laughed it off.

"This is not the job I was praying to God to find for me," she confessed. "But it is very gratifying. I know that I am making a mark in my patients' lives that neither of us will forget."