Advocacy, agriculture, Climate Change, Corruption, Economy, Environment, International Relations, Public Health, Tourism, transparency, U.S. Relations, Uncategorized

The Case of Privatizing Happiness

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Dozens of reporters, spent an entire day, braving the heat to cover a story concerning one of the major issues Voices is currently working on. The story is about the implementation of mega-tourism, sponsored by the Millennium Challenge Corporation in the Lower Lempa Region of El Salvador. The main theme is it’s negative impacts on the communities living in and around the Jiquilisco Bay.

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IMG_0040 IMG_0055  IMG_0031 An article published by the Foreign Policy Journal said: “U.S. foreign aid is expected to promote poverty alleviation and facilitate developmental growth in impoverished countries. Yet, corporations and special interest groups have permeated even the most well-intended of U.S. policies.”

The United States has $277million in aid money to grant El Salvador and much of it will promote tourism in the Jiquilisco Bay by funding infrastructure projects like wharfs ans marinas in order to encourage private investment.

IMG_0116 IMG_0108 IMG_0092 IMG_0134Voices has been working extensively with communities and NGO’s in the Lower Lempa region to ensure that residents are bring represented, rights are being protected and those in charge are being held accountable for non-ethical practices. La Tirana and El Chile are two communities most affected by the plans and have expressed concerns about the potential threats to the land, the water, the culture and the economy of their communities. Voices even collaborated with them to create a detailed report on the situation.                >> Read the report here                                                                                                        >> Read the article here

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IMG_0149  IMG_0009“They are privatizing our happiness. They are stealing our smiles.”  La Tirana’s community leader said as he looked over the bay where kids were playing. Thanks to the efforts of leaders like him, many of these people here know what’s going on. They know that this isn’t free money coming into their communities and they are banding together to demand that their lives and rights be taken into consideration.

The day’s event was a great opportunity for exposure. Many diverse, national and international journalists were able to experience the reality these communities face. These communities have been taking good care of the natural resources through climate change, contamination and even flooding with little to no help from the government. To them, these resources are their lifeline. This is something that tourists who are primed to vacation here will never understand.

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El Salvador Government, Public Health, Womens issues

Beatriz and Abortion in El Salvador

Doctors recommend that Beatriz, a 22-year-old Salvadoran woman with Lupus, terminate her 19-week pregnancy due to the associated risks of morbidity or mortality. Her doctors are worried that because Lupus has damaged her kidneys and caused other health issues, she is at high risk of preeclampsia, pregnancy related hypertension, and other life-threatening complications. Also, her fetus has a lethal anomaly that, aside from any of Beatriz’s health issues, will result in its eventual demise, either in utero or immediately after its delivery.

We first posted about Beatriz’s case last week when Amnesty International asked the international community to write to members of the Salvadoran government on her behalf.

In 1998, El Salvador completed a series of reforms, which included changing the constitution, resulting in an absolute ban against abortion. As reported by the New York Times Magazine in 2006, the ban is so restrictive that doctors cannot remove ectopic pregnancies (when a fertilized egg stays is implanted in the fallopian tube instead of the uterus), which have no chance of survival and put the mother’s health at risk.

After years of quiet activism a growing cadre of civil society organizations and human rights activists are speaking out against the absolute abortion ban and its extreme application. Over the past several years, activists have been defending women who have been accused of having an abortion, some of which have been convicted in a court of law and sentenced to 40 years in prison. Civil society, however, has really coalesced around Beatriz’s case, which is a potentially tragic example of the impact that the ban has on Salvadoran women.

This movement, which has become more vocal in recent weeks, is being met with fierce opposition from the Catholic Church and Fundación Sí a la Vida (Yes to Life Foundation), which represents some 50 pro-life organizations.

The Catholic Church and Yes to Life oppose allowing Beatriz to terminate her pregnancy, even if it means that she loses her own life. The Archbishop of San Salvador José Luis Escobar, said, “it is my understanding that the mother of the child is not in an intensive care situation… For me, it is the baby in utero that is in more danger because there is a movement to terminate its life. Only God knows how long this baby that they want to kill will live.”

Julia Regina de Cardenal, the President of the Foundation Yes to Life said “She [Beatriz] is stable, and able to speak, what we want is her physical and emotional wellbeing; we are trying to get close to her to help her. Carlos Mayora Escobar, also from Yes to Life, said “these people, why do they want to legalize abortion in this country? For political reasons, for ideological reasons, for reasons unknown. We always try to defend the rights of the women.”

As we posted last week, doctors at the National Maternity Hospital have filed an appeal with the Salvadoran Supreme Court, asking them to give the okay on terminating the pregnancy to save Beatriz’s life. The Court has yet to respond, but the magistrates asked the National Bioethics Commission of El Salvador (CNBES, in Spanish) for its opinion, which they provided this week. The CNBES advised the Court that Beatriz’s doctors should be allowed to immediately proceed with the potentially life-saving procedure.

The Citizens Association for the Decriminalization of Abortion, which advocates for legalization of abortion in El Salvador, supports Beatriz’s case. They are using it to demonstrate why they believe abortion should be safe and legal. On Thursday, April 25th, the group is presenting Beatriz’s case before the Inter-American Court for Human Rights, asking them to intervene.

Lic. Oscar Luna, the Ombudsman for the Defense of Human Rights in El Salvador, published a statement on April 16 also supporting Beatriz’s case as a human rights issue, stressing the mother’s right to life. He wrote in 2009, “the complete ban of abortion greatly increases the pain and suffering of women and girls, including those who seek medical attention for complications that require an abortion… because the penalty for abortion causes physical pain, fear, depression, and prison. In many occasions the suffering can lead to death or suicide.”

Luna says, “During my term [as Ombudsman], I have insisted that the human rights approach to health care ought to have an integral focus, taking into account the needs and requirements particular to women during all the different stages of life; and that in all forms, it is urgent to double up the efforts to decrease the causes of mortality and morbidity in El Salvador.” He concluded that the medical team should “use all means necessary to protect Beatriz’s right to life, health, and personal integrity.

In 2006, the New York Times Magazine published a long article on the abortion issue in El Salvador called the Pro-Life Nation. In addition to detailing the experiences of women who have had abortions in El Salvador, the article discusses the constitutional ban and abortion laws, and how the doctors/police/prosecutors enforce them.

In one sense, Beatriz’s case is extreme – it is a potentially life or death situation for her. But in many ways her case is not that different from other Salvadoran women who are socially and economically marginalized, lack knowledge of or access to contraception, and have little control over when and with whom that have sexual intercourse.

If you want to help Beatriz, please visit the Amnesty International website (click here).

Advocacy, Public Health, Womens issues

Please Help to Save Beatriz’s Life – Sign on to the Amnesty International Letter

Amnesty International is asking people to sign on to a letter supporting Beatriz – a 22 year-old Salvadoran women who is 4 ½ months pregnant. Her doctors have diagnosed her with kidney disease and Lupis, and said the fetus doesn’t have a large part of its brain. Beatriz’s life is at risk if she does not terminate her pregnancy. The hospital treating Beatriz has asked the Ministry of Health for permission to provide Beatriz an abortion, but officials have ignored their request.

El Salvador has a constitutional ban against abortion, which has resulted in several serious issues for poor women throughout the country. There are too many cases in which doctors and police have accused Salvadoran women of trying to terminate their pregnancies when they were really having a miscarriage. There are many other cases in which women have died trying to terminate pregnancies that they didn’t want, either because they were raped or their impoverished situation made it impossible for them to care for another life.

To be clear – this is an issue that affects poor women. Salvadorans who need to terminate a pregnancy and have money can go to private doctors and have an abortion without the risk of being arrested. They also have access to information and contraception that is not readily available in public schools or health clinics.

Poor women who can’t pay for a private doctor and have to rely on state facilities do not have any options available to them, other than trying to terminate their pregnancy at home. On March 16, the Inter-American Court of Human Rights held a hearing on the impacts of the strict abortion laws in El Salvador.

Unfortunately, abortions are sometimes necessary to save the life of the mother, as it the case with Beatriz.

Please help Beatriz by sending the letter to the Ministry of Health – here is a link to the Amnesty Letter. The letter and instructions are in Spanish – if you fill out the fields under the email, Amnesty will send you an email with the letter and email addresses. All you have to do is reply to the letter (make sure to delete the instructions, leaving the letter in the body of the email). If the email addresses don’t automatically fill in, you can cut and past them.

Thank you!

Public Health

Basic Health International and Cervical Cancer Screening in El Salvador

Our friends at Basic Health International (BHI) are have been in the news quite a bit lately. Last month, Dr. Miriam Cremer and BHI were written-up in the New York Times for their efforts to combat cervical cancer in El Salvador. BHI is using a new screening technology called careHPV to detect early signs of cervical cancer, especially in rural and under-resourced populations. Dr. Cremer says BHI plans to screen 30,000 Salvadoran women over the next two years.

Yesterday they held an event with the Ministry of Health and MD Anderson to sign a memorandum of understanding (MOU) that will “strengthen their commitment to work cooperatively to impact cancer and especially highly preventable diseases like cervical cancer.” The event yesterday was part of a cervical cancer prevention symposium taking place this weekend in San Salvador.

BHI is a non-profit organization striving to eradicate cervical cancer and improve women’s health in Latin America and the Caribbean, with a large presence in El Salvador. They focus on four areas: patient care, medical training, health policy, and research. BHI offers women training on how to use the careHPV screening, and for those with abnormal cells they offer free treatment, including housing, transportation, and meals while at the clinic San Salvador. The BHI staff also trains local health promoters on how to give cervical cancer education, and local doctors in the low-tech see-and-treat VIA and cyrotherapy.

BHI is partnering with Ministries of Health in Latin America to improve cervical cancer screening programs and education, and help Ministries develop training manuals. Their research focuses on cervical cancer screening methods, cervical pre-cancer treatment, screening and treatment service-delivery, and contraception methods.

Cervical cancer is one of the leading cancer killers of women worldwide. Gynecological visits and pap-smears have worked to reduce the numbers of cervical cancer deaths, especially in the developed world. Low-resource areas of the world do not always have the availability of equipment, trained medical professionals, and funding to administer these life-saving exams. Additionally, gynecological exams may be frowned upon or discouraged in some cultures, which make the administration of such tests extremely difficult. Traditional tests require multiple visits and this poses problematic for impoverished and rural women because of logistics, time constraints or finances to return to the clinic or doctor.

CareHPV is a screening method developed by Quiagen (a Dutch Company). It’s a DNA swab test that identifies the papillomavirus that causes cervical cancer. The test is revolutionary because it can be self administered by women in their comfort of their own homes. The test does not require running water or electricity, which is ideal for impoverished women in rural communities. Results are available within two and half hours so if administered in a medical office setting, screening and treatment can happen in the same visit.

BHI is one of those international organizations that really impacts quality of life for women throughout El Salvador and Latin America. Dr. Cremer and her teamwork tirelessly to make sure that fewer and fewer women die of a treatable disease.

Economy, Public Health, violence

Cities: El Salvador’s Growing Problem

Urbanization is something that every country faces at one point or another in its development. The US, for example, experienced urbanization during the industrial revolution and on to the early 20th century. Today, many developing countries are also experiencing it. Because it is part of the path to development, urbanization is an indicator worth analyzing in the context of El Salvador as it becomes increasingly problematic, specifically in terms of poverty, violence and health.

 

As nations’ economies move from rural farms to more modern technologies, cities begin to form as hubs for commerce and other economic activity. Urbanization’s momentum grows when even more poor people then decide to relocate to the city in an effort to find better opportunities. This can be seen from Mexico City to Shanghai. Problems arise, however, when cities begin to get overcrowded and the poor create squatting communities along the outside of the cities. Often times these individuals have no rights to the land; more so, living conditions in these communities are terrible.

 

El Salvador has cities that are not unlike those of other developing countries. In fact, about 60.3% of Salvadorans now live in urban areas. El Salvador’s main urban hubs are San Salvador, San Miguel, and Santa Ana. While Salvadorans decide to go to cities to pursue better lives, city life is often not that glamorous. Typically, urban homes are made out of bricks and cement. Homes in the slums however, are essentially huts made out of aluminum, plastic, and cardboard. It is important to note that these homes are especially susceptible to constant flooding in the rainy season. There are also instances where the single water source in these communities is contaminated.

 

Urban poverty in El Salvador currently stands at 56%; that is, more than half of those living in cities are barely able to afford to survive. Fewer job opportunities and high costs of living explain why urban poverty is so widespread. Even so, the urban population in El Salvador is growing by about 1.9% each year while the rural population is only rising at 0.6% each year. It becomes a problem when far too many Salvadorans are living in the cities because the government is not able to provide the necessary services to everyone.

 

Another problem related to urbanization is urban violence. Poverty alone does not explain why crime in cities is more common. It seems that inequality, which is more distinguishable in urban areas, is also a key indicator of crime. Inequality, coupled with daily living conditions, is likely to result in conflict and violence. Violence specifically affects developing countries by stifling necessary economic growth. Urban conflict drains financial capital by requiring greater investments in judicial services and healthcare. Human capital is also reduced by the presence of persistent violence. Deaths and reductions in life expectancy, lower levels of personal security, fewer educational opportunities and lower productivity in the workplace all function to weaken the labor force. Lastly, social capital is also reduced through the ongoing fear and lack of trust within communities that result in less coordination.

 

Health is yet another problem affected by urban growth; slums are inherently unhealthy living arrangements. Because these individuals do not own the land and are residing in informal communities, they cannot demand better living standards from the government. Living in city slums, like those in San Salvador, Santa Ana, and San Miguel, where there has been little to no urban planning also facilitates the spread of illnesses. More than that, traffic accidents and pollution, two seemingly trivial consequences of urbanization, account for an alarmingly high number of deaths and illnesses.

 

While the government has not done much to address the issue of living conditions in the cities and slums, it has attempted to address the issue of crime. As a result of its high crime rates, El Salvador has passed a substantial number of laws aimed at reducing crime. With mixed success, the government has remained dedicated to fighting crime since El Salvador became one of the ten most crime-ridden countries in the world. With that said, the government has done little to address the issues of poverty and health in the growing urban areas.

 

Indeed, urbanization signals progress, however it comes with its own unique set of problems. El Salvador does not have the necessary mechanisms in place to offer everyone in the cities the resources and services they need to pursue a better life. Instead, urban poverty is growing and living conditions continue to deteriorate. Poverty, violence, and health are all variables that interact with one another to create the reality of city life in El Salvador today. As such, one of these factors cannot be remedied without the other two being addressed as well. The government will be forced to address it in the coming years as more and more Salvadorans continue to move to the cities.

 

El Salvador Government, Public Health

Women’s Rights Debate Heats Up in El Salvador

El Faro published an article last week discussing the United Nations’ appeal to El Salvador that it amend its laws to accommodate safe access to abortions. The United Nations’ Human Rights Committee issued a report last Thursday asking El Salvador to decriminalize abortion and revamp its dismal record of women’s rights violations. The report emphasizes, “El Salvador is one of the only five countries in the Latin America that maintains an absolute prohibition on abortion, including under circumstances when pregnancy endangers the women’s life.”

El Salvador’s laws restricting abortion have become increasingly restrictive in the last two decades.  Until 1998, abortion was illegal except in cases of rape, incest, fetal anomaly, and when the mother’s life or health was at risk.  Starting in 1998, El Salvador instituted a series of reforms restricting women’s access to reproductive service.  Chapter II of El Salvador’s revised Penal Code now “penalizes women who induce their own abortions or give their consent to someone else to induce an abortion; doctors, pharmacists or other health care workers who practice abortions; persons who encourage a woman to have an abortion or provide the financial means to obtain an abortion; and persons who unintentionally cause an abortion.” The penalty ranges from two to eight years in prison. In 1999 the constitution was amended to define a human being “from the moment of conception.” Although El Salvador is party to many international treaties guaranteeing women’s and children’s rights, and although El Salvador’s constitution grants recognition to these treaties and conventions as equal in status to national law, the country continues to restrict women’s reproductive rights.

The UN report also highlights the concern over violence against women and girls in the country, including rape and sexual violence, which it characterized as “pervasive and widespread.”  The report “demonstrates how El Salvador’s complete ban on abortion health services directly violates of women’s and young girls rights to equality, life, liberty, health and be free from torture. Furthermore, it violates every woman’s right to receive medical attention while preserving patient confidentiality, which is violated by medical personal that have been pressured by the police to report these incidents.”

A blog article in yesterday’s Ms. Magazine touched on the concerns over the links between restricting reproductive rights and increased violence against women when discussing the case of Irma Medrano, a Salvadoran woman who fled the country in 1995 and settled in California.  She has been living with her sister and hoped to escape the dangers of her abusive husband back in El Salvador, whom police investigators refused to investigate citing the violence as a private matter.  Although the Obama Administration has previously recognized fear of domestic violence as a justification for asylum, Ms. Medrano is currently in the process of being deported back to El Salvador despite word that her husband will be looking for her once she arrives.

Access to abortion became a subject of public debate earlier this year after Maria Evelyn Martinez, Director of the Salvadoran Institute for Women (Idesmu, for its name in Spanish), ratified the Consensus of Brazil without the President’s explicit consent. The Consensus was developed during the 11th Regional Conference for Women in Latin America in the Caribbean, an event sponsored by the Economic Commission for Latin America and the Caribbean (ECLAC) and the United Nations, which took place on the 16th of July in Rio de Janeiro, Brazil. The Consensus calls for greater protection of women’s rights, and asks that all signing countries reconsider any laws that punish a woman for seeking an abortion and promise safe and secure access to abortion where it is permitted by law. By ratifying the Consensus, Ms. Martinez agreed that El Salvador would revisit its strict anti-abortion laws. Her action is widely unpopular and was harshly criticized before being overturned by President Funes.

Martinez signed the document with the understanding that she was authorized to participate fully in the forum using only her own judgment. In the governing laws of Idesmu it specifically states that the director is authorized to “create, circulate, and promote effective compliance with the agreements ratified by El Salvador in relation to the improvement of women’s quality of life” (Idesmu Charter). Given this language, Ms. Martinez felt that she was able to sign on behalf of the nation without the President’s specific approval.

However, in a public statement in late August, Funes criticized Martinez’ actions and said that he has “never given any consent for the revision of the country’s laws.” He continued, “the national constitution states that life begins at the moment of conception, and as long as this constitution is in effect we must respect its laws” (El Faro). He also stated that he would communicate with the coordinating bodies of the Consensus of Brazil to inform them that Ms. Martinez was not authorized to sign the document and that El Salvador would be withdrawing its signature from this aspect of the agreement.

Ms. Martinez has defended her actions by pointing out that this is the fifth time she has signed an international document calling for the revision of El Salvador’s abortion laws, but no President (including Funes) has ever criticized these decisions in the past.

Official responses to the event were mixed. Many FMLN representatives have asked for improved communication and coherency between government offices so that misunderstandings like this one can be avoided in the future. The Vice-minister of Health, Violeta Menjivar, and the second in command for the FMLN Legislative group, Norma Guevara, openly expressed their disappointment at the President’s refusal to reconsider the law. El Faro took this opportunity to conduct an in-depth interview with Ms. Martinez, questioning her about her role as Director of Idesmu and her personal beliefs.  Archibisop of San Salvador, José Luis Escobar Alas, publicly announced his support for President Funes’ decision to uphold the constitution.

In contrast, public response to the event has been overwhelmingly consistent, with almost all Salvadorans opposing any changes to this aspect of the constitution. El Diario de Hoy polled public opinion on the issue and found surprisingly homogenous results: 93% of respondents said they were against modifying the constitution to allow abortion; 76% support Funes’ decision to modify El Salvador’s commitment to the Consensus of Brazil, and 32.7% believe that Ms. Martinez is “mentally ill” for signing the document.

With such an overwhelming public response and the clear agreement of the President it seems unlikely that El Salvador will seriously reconsider its abortion laws anytime soon. El Salvador remains one of only 3 countries in the world that have increased restrictions to abortion care in the last 50 years; regulation in every other country has stayed the same or become more lenient over time.

Public Health

Epidemic of Bacterial Conjunctivitis Declared in 12 Departments

In addition to the increase in cases of dengue and repertory illnesses the Ministry of Health has stated that El Salvador is also experiencing an epidemic of Bacterial Conjunctivitis, commonly known as pink-eye. Conjunctivitis is a microbial infection involving the mucous membrane of the surface of the eye.  It is usually a benign, self-limited illness, but can be serious or signify a severe underlying systematic disease. Occasionally, significant ocular and systematic morbidity may result.

The Ministry of Public Health and Social Welfare (MSPAS) reports that the increase in cases of Bacterial Conjunctivitis led them to them to declare an “alarm” in 12 of the 14 departments of El Salvador. The only departments not included in the declaration were San Salvador and San Miguel.

As of August 2, 2010, 38,358 cases of Bacterial Conjunctivitis have been reported, compared to only 2,400 cases in 2009. Additionally, authorities have noted that the greatest increase in cases observed has occurred in the last few days. The Director of Health Surveillance, Julio Armero explained, “just on Sunday (August 1st) 76 cases were reported and on Monday we had 56.” In response the ministry has begun to work on a campaign to prevent further spread of this illness.

Violet Menjivar, the Vice Minister of Health clarified that the alarm was only declared in the 12 departments where an epidemic of Bacterial Conjunctivitis is present. People living in these departments should therefore undertake proper precautions to avoid catching the illness these include, washing ones hands and not touching ones eyes or mouth. These precautions are similar to the ones recommended to prevent respiratory illnesses.