Salvadorans continue struggle against health care privatization
Thousands march in the streets of San Salvador to protest
25 October 2002
We have received another request for a letter of support for Salvadorians fighting against the privatization of health care. This time the letter came from El Salvador and they sent additional information plus a sample letter to send to the President of El Salvador. If you have not answered yet, please feel free to use their sample letter or modify it to better express your concerns. Please, share your concerns with the Canadian government about its responsibility in this process, as it was explained in the first action alert on this issue.
In addition to that, there are some new developments:
- Thousands of Salvadorians took to the streets of San Salvador on October 23, to protest against privatization of the health care sector. There were doctors, other health care workers, patients and many other supporters. This is the second massive public demonstration against health care privatization. More than 30 ISSS workers have already been fired, and 342 more doctors could now be fired for participating in the strike (ISSS is the acronym for Salvadorian Institute for Social Services).
- The Physicians Union has just published an article (in the Journal of the Human Rights Commission of El Salvador) describing how the government of El Salvador has diminished its financial support for public health care and, at the same time, undertaken a campaign of disinformation, to convince the people of El Salvador that the workers are the ones responsible for the crisis of the health care sector, that the system is beyond repair, and that the only solution is privatization.
- A group of journalists from El Salvador, "Journalists against corruption", has denounced a bill sent to the Salvadorian Congress that will restrict access to information on the proposed new health care system. They say that the purpose of this restriction is that the new system will be managed without any monitoring from media nor from the public in general. They point out that the Salvadorian Institute for Social Services is one of the institutions most affected by corruption, and that the government has never showed any interest in bringing these practices to an end. According to Transparency International, El Salvador is a country with a high degree of corruption.
San Salvador, October 2002
Dear friends,
El Salvador is now experiencing one of its worst social, political and economic crises ever, as a result of neo–liberal reforms imposed by the international financial organizations. The Peace Agreements signed in 1992, under the mediation of the United Nations, don't guarantee any more the democratic process in public institutions. Moreover, the extreme right wing government policy of the Nationalist Republican Alliance (ARENA, its acronym in Spanish) is leading the country and its citizens to a new political and social conflict.
The successive governments of ARENA, in power for more than 13 years, have already privatized the financial services, telecommunications, electricity, and the pension systems; the current government has initiated privatization processes for harbours as well as airports and, even worse, it is trying to privatize public health services.
In his inaugural address to the people of El Salvador, referring to the health sector, President Francisco Flores promised to promote a reform in accord with the health professionals. In this respect, he appointed the Health Reform Council, which included various sectors of society. In December 2000, the Council handed over a "Comprehensive Health Reform Proposal".
Counteracting this proposal, the Salvadorian government have started a series of de facto privatization reforms, as it can be seen in the decision to hire private companies to supply food, security and cleaning services in public hospitals. Even worse, in some places, they are now contracting out medical and paramedical services.
All these actions have caused an increasing public discontent and a strong movement of resistance among the medical profession and the workers of the health sector, who see how people's lives are being put in jeopardy. The last conflict broke out in September. The lack of dialogue and the lack of commitment of the government to not go on with privatizing the health sector, have resulted on a strike at the main public hospitals, which now provide only emergency services.
This struggle for the maintenance of the public health sector is supported more and more by many municipalities, farmers and trade unions, women associations, environmental organizations, consumers, and human rights defenders. The last evidence of this strong support was the demonstration organized on October 16, which gathered more than 25,000 people on the streets of San Salvador.
Despite of this evident rejection by the population, on the same October 16, President Flores sent to Congress a series of bills in order to establish a new system of "health by objectives". Its main purpose is the privatization of health services. It will allow national and international private companies to treat Salvadorians' health as a commodity, and puts health care out of reach for the poor.
Nevertheless, citizens' pressure did have its effect on the National Congress; on October 17, the Congress approved a "State Decree Guaranteeing Health and Social Security" which prohibits any privatization process to be undertaken in the health sector. This Decree merely applies the Constitution of the Republic in expressing that "The Republic's inhabitants' health is a public good. The State and the citizens are obliged to see to its conservation and restoration". Many social organizations of El Salvador that fight for the maintenance of participatory democracy, peace and social justice, feel deeply concerned and really worried about the turn that could take the situation of the country, should the president reject the "State Decree Guaranteeing Health and Social Security". This is why we are asking the President to ratify the Decree as soon as possible.
The letters are to be sent to the following addresses:
Lic. Francisco Flores
President of the Republic of El Salvador
casapres@casapres.gob.sv
Fax: 011 503 243 9947
Congress of El Salvador – Environment Commission
Comision_medio_ambiente@asamblea.gob.sv
Fax: 011 503 281 9523
Please send all messages with copy to the Medical College of El Salvador (Professional Association of Physicians)
Concolmed@telesal.net
Fax: 011 503 260 0324
Fraternally, in the name of Salvadorian Society,
Armando Flores
Executive Director
Consumers' Defence Centre
Mr. Francisco Flores
President of El Salvador
Presidential House
San Salvador, El Salvador, Central America
Mister President,
We would like to share with you our great concern about the health care crisis in El Salvador. We believe it indicates profound structural problems that have an impact on access and quality of the public health services for Salvadorians.
We think, Mister President, that a reasonable way to prevent this crisis from getting worse is to encourage dialogue and understanding, to be able to reach a national agreement on the defense of the human right to health, through a commitment to prohibit the privatization of health services in any way.
In this respect, the "State Decree to Guarantee Health and Social Security" approved by the Salvadorian Parliament on October 17, represents a step towards this national agreement, we welcome this decision. We respectfully ask you, Mister President, to ratify this Decree, so that it becomes law and creates adequate conditions to bring doctors' and health care workers' strike to an end. At the same time, it would open a dialogue to define and implement a health reform based on consensus, one that would guarantee the Salvadorian population a complete and equal access to health services.
Mr. President, you expressed, in your inaugural address to the Salvadorian people, your desire to work with the health professionals towards health care reform. To reach this purpose, we take the liberty of asking you to withdraw your reform proposal called "Democratization of the Health System" from the legislative agenda. This proposal treats health care as a commodity and leaves it out of the reach of the poor. Therefore, it attempts against the social stability of the country and jeopardizes the democratization process in progress in El Salvador.
Finally, Mister President, we will keep informed of the progress in this dialogue and truly hope to receive, in the near future, positive and encouraging news about maintaining peace and strengthening democracy in El Salvador.
Sincerely yours,