In the clinic of Adios Tatuajes in San Salvador, young gang members can remove tattoos that indicate their gang membership. Many poor urban youngsters become part of the youth gang in their neighbourhood. Once part of the gang, there is no way out and violence and crime will determine their daily lives; a future perspective of either ‘hospital, prison or death’ as one of the youngsters puts it. Rival gangs are always near and gang members in El Salvador can be caught and put in prison by the police at any time. Although it is not possible to leave the gang and betrayal will be punished with death, some have the courage to leave and start a life outside the gang.