The political pot is boiling over in the small Central American country of El Salvador, where a dramatic and important battle is being waged over the fate of the public health care system, which the right-wing governing party, ARENA, is in the process of privatizing. Over the past five months, this struggle has dominated Salvadoran politics and heightened political tension to a level that has not been felt in the country since the twelve-year civil war ended in 1992. As a Canadian, knowing that the same, albeit quieter, battle is being played out in my home country, I have been watching with great interest and concern.
My host organization here, CRIPDES (Organization for the Development of Rural Communities in El Salvador), has been very involved with the effort against privatization and with them I have been periodically swept up and then terribly disappointed with the successes and failures of this fight. Throughout, two aspects of popular struggle against neo-liberalist policies (popularly referred to as globalization), such as privatization of basic government services, have become clear to me. One is the immense strength the people yield when standing united, and the other is the overwhelming power and danger of that which they are standing against.
To understand the dynamics of this battle in El Salvador, one first must understand the demographics of the country, where, as in the rest of the Majority (or Third) World, there is a small middle and a minute upper class, while most of the population is poor and rural. For instance, 23.4% of all Salvadorans live in "extreme poverty" on less than a dollar a day, and 53% of the nation's income is in the hands of 20% of the population (UN Development Program). Privatization anywhere, whether in Canada or El Salvador, will place health care out of the reaches of the poor. However, in El Salvador this means that the vast majority of the population will not have access to even the most basic health care.
Perhaps due to the drastic nature of this situation, the struggle here to counter the government's privatization policies has united a vast and traditionally unlikely popular movement. Attendance at demonstrations in the capital of San Salvador last October, November and December continuously exceeded expectations, culminating in the second "White March", which at 200 000 persons strong, was the largest since the war. As could be expected there were many representatives from the FMLN, the lead opposition party which denounces privatization as enthusiastically as it encourages public protests; representatives of unions and various municipalities; and women's, students, human rights, and environmental organizations. However, it was the presence of middle class professionals, especially the majority of this country's 2000 or so doctors, which both brought real weight to the protest and spoke to the grave consequences of privatization. Although financially likely to benefit from privatization of the health system, El Salvador's doctors have been striking in solidarity with the protests, in three to eight day periods, for the last four months.
This inspiring display of broad social activism brought results. On the 14th of November of 2002, the controversial "State Guarantee of Health and Social Security" Bill, which was written by striking public workers, and effectively outlawed privatization of health care and other basic services, was ratified. This marked a historic and deserved victory for the people of El Salvador and was joyously celebrated with spontaneous street parties. The celebration, however, was short-lived. On December 19th ARENA joined forces with another rightist party and overturned the law. And so we come to the other side of the coin, the incredible momentum behind neo-liberalist policy and thus, the seemingly unstoppable power of its defenders.
It is accepted amongst El Salvador's Left that ARENA's extremist policies are just a manifestation of the neo-liberalist doctrine that the government of the United States, and international economic institutions such as the IMF, are pushing on Latin American and other Majority World countries. The entire movement understands the phenomenal power of their enemy and the global context of their situation. They see their struggle and the FLMN, their strong and vocal Leftist opposition party, as small sources of light in the dark reality with which neo-liberalist policies continue to blind the world's poor. Demonstrating this, in a show of amazing persistence and optimism, or maybe just simple necessity, the strikes (despite many lay offs and threats of more) and the protests have continued.
I have been inspired by the organization, energy, and strong, clear convictions of the popular movement in El Salvador and have been disgusted by the idea of the commodification of health care, anywhere in the world. Right now, the media is full of rhetoric promoting the privatization of the most basic necessities for survival, such as public health care, as a "practical" reality of the world we live in. Rarely, however, does this rhetoric ever address the long-term implications on the world's majority, or feasible and more responsible alternatives. My experience in El Salvador, one of Latin America's "freest" economies, has shown me the dire consequences of a government adopting bottom-line priorities, with general populations left to fend for themselves, while high-level government officials and their corporate friends grow rich operating an exclusive and exploitive economy.
It concerns me that Canada may also embrace this path and abandon the principles of equal and universal health care, which we have been proud of for so long. As a country, we are economically and politically stronger than our Central American neighbours, and have an opportunity to be an example of compassion and justice in a continent increasingly prone to the-rich-get-richer-while-the-poor-get-poorer policies. As people concerned about the growing inequalities in the world, we have much to learn from Latin American activists. As Canadians, we must recognise our power as a population in a democratic country, as well as the incredible global momentum of neo-liberalism, and unite to promote responsible governance while it is still something we are defending, rather than struggling to recapture.
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