Anneke Paterson

Bitten by the Moon

“There is a saying used in El Salvador that is rooted in mysticism; when the birth of a child with a birth defect is observed, family and doctors will say, “mordido por la luna” – or ‘bitten by the moon’, to explain the visible anomaly. In El Salvador, there is a significant population of people that will likely never be able to receive the surgical treatment they need for birth defects and other severe physical conditions alike. The barriers to access extend beyond income and socioeconomic standing — often surgeons will refuse treatment because they lack the specialized skill, equipment, or adequate teams to take on more complex procedures. Many of those that are able to afford their surgeries are denied them anyway; surgeons face challenges within the government in seeking funding and advocating for better equipment. These factors deeply and detrimentally affect those that need specialized surgical care in their personal lives. Many that have a distinct physical deformity or affliction are nearly barred from their communities, and are ostracized if they are not able to contribute to society in the expected ways such as in production and labor. They face extreme difficulty beyond their physicality, and the emotional trauma that ‘being different’ implies– many are forced to travel internationally to the States or to Europe to receive their treatments. They lose their jobs, leave behind family and must find financial support to enable them to travel and stay out of their home country for significant periods of time. Those that are able to find help within their country may not make the “priority list”, meaning that although their condition may be severe, if they are stable, they must wait. These images illustrate the struggles behind this lack of service for the population of El Salvador and also brings to light the resilience of the people that must fight for necessary services. Many will fall through the cracks in a societal, governmental, and political system that is designed to serve only those that are healthy and “able-bodied”. While there are many factors at play here, I have chosen to focus on the people of El Salvador and their stories in hopes of providing answers to the question – what is life like with a physical deformity where help does not exist?”






Anneke Paterson was born with a rare syndrome which has required her to have multiple surgeries at different stages in her young life. It is from this background that Anneke has gained an acute interest in not only the evolving cultures of her generation, but in the healthcare of her generation. Anneke has visited families in El Salvador, Guatemala and México in search of understanding the implications of what is life like when there is little to no access to required surgeries, while already facing the socioeconomic challenges of poverty. Based in Austin, Texas, Anneke is currently attending college part time, working toward a bachelors in global health policy and anthropology. Anneke’s photographic work has been published by The New York Times, National Geographic Travel, National Geographic Books, and the Texas Tribune



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Anneke Paterson

3 thoughts on “Anneke Paterson – Bitten by the Moon”

  1. hharry —

    Thank you for your interest. The surgical team that I have worked with over the past few years has been Austin Smiles Plastic Surgery Foundation.


  2. I agree with hharry, important work; and very well executed. I would have liked captions (I always do as an aid to deeper understanding) but they are on Anneke’s website, which is well worth a visit.

    Thank you Anneke and thank you Burn magazine for this factual essay.

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