Every year there are fewer doctors per person, so young doctors have to become unemployed or leave for the exclusive private sector of medicine. "It's not a question of having enough doctors, it's a problem of not having enough employment for them in the public sector," he added.
Espinoza said he shows Michael Moore's movie Sicko--chuckling and savoring the pronunciation of the word--to his medical students as the best overview of the current crisis.
Of the four main distributors of medicines, those who broker between manufacturers, hospitals and pharmacies, three are owned by a cousin of the outgoing president, Antonio Saca, and the other by the family of a former president, Alfredo Cristiani. It gets worse: sometimes the system purchases medicines, including cancer and HIV medications, just before they expire and can no longer be given to patients.
Funding for increased access therefore will have to come from wringing efficiencies out of a system in which power is both bloated and maldistributed, a very difficult task. CAFTA worsens the crisis by extending patents, fostering market prices and "not considering healthcare a human right but a service." There still is room for negotiations over CAFTA, according to Espinoza, but it's a long way to his dream of a national healthcare system for Central America as a whole. As a leader of the recent battles against further privatization, he believes a greater social movement will be necessary "to address the social determinants of health." As for the public, he says it wants "total" and "radical reform" in the direction of universal care, and that its voice will be heard.
Now that relations with Cuba are being affirmed after fifty years, might Cuban doctors and medical schools help the transition in El Salvador? "They could be a good resource now that we are trying to revamp everything, because they have a different perspective," Espinoza replied; but the problem remains a Salvadoran one, of the power of social movements and former revolutionaries to change a system still designed to benefit a few.
The role of solidarity movements
They came on foot, or often in the trunks of cars, separated violently from their families, often in the hands of uncaring coyotes who took the little money they carried. One-tenth of the Salvadoran people became war refugees living in Los Angeles alone. "The solidarity movement had a huge role in this victory," Linares reflects. "Our dreams are the dreams of the solidarity movement."
It is important to remember this movement in its many forgotten strands, for its tenacity, variety, duration and lasting effects. Refugees, most of them undocumented, beginning without material resources, eventually formed service and advocacy organizations such as the Central American Resource Center (CARACEN) El Rescate (the Rescue) and the Salvadoran-American Leadership and Education Fund (SALEF), which became extremely influential.
Carlos Hernandez Vaquerano is the leader of SALEF, which has provided hundreds of scholarships to Salvadoran youth and carried on voter education campaigns. He was in El Salvador with a delegation of longtime allies. His seemingly exceptional profile is like many others. He was born in El Salvador in 1960, and three of his brothers--Marciel, Numan and Osmini--were kidnapped, murdered or disappeared by death squads in the 1980s. Encouraged by his family to leave before he himself was killed, Carlos made his way to Mexico in October 1980 and crossed the Tijuana border while lying face down on an engine block under the hood of a GMC truck. He was 20 years old, leaving behind a mother and several siblings. His father died of alcoholism when Carlos was 4.
He immediately joined the Los Angeles branch of the FMLN, whose offices were on Bonnie Brae street adjacent to MacArthur Park, as a volunteer, supporting himself as a day laborer and factory worker. On Sunday mornings he and his friends made and sold tamales door-to-door to raise money for El Salvador, handing out political leaflets at the same time. Soon he began working with the sanctuary movement, a vast underground railroad established mainly by religious organizations to shield and harbor escaping Salvadoran and other Central American refugees. More than 300 churches and synagogues nationally declared themselves safe havens, and at least 100,000 Americans signed pledges of active support. After years of solidarity work, he went on to lead SALEF, and became a prominent supporter of the Funes campaign.
Another exile was Rosanna Perez, who came to the United States in the 1980s after the authorities repressed the university student movement, disappeared her husband, and kidnapped and tortured her in prison for two years. She crossed the border on foot; her daughter, Sara, 2 years old, was being smuggled ahead. For years afterward, the daughter dreamed about hiding Rosanna in a closed room while a man was trying to abduct her; only many years later, when she was a UCLA student, did Sara call Rosanna to ask what happened. Both started crying.
Once in LA, Rosanna adopted the alias "Sara Martínez," and began working with the Comite Santana Chirino Amaya, named after a Salvadoran deportee who was tortured and killed, and also with El Rescate and a clinic named for Monsignor Romero. At first she thought the war would end in a couple of years and she could return home. Instead, she found herself joining the sanctuary movement, learning English, and speaking before audiences of ignorant but sympathetic church-goers. "Believe me, those were days of meetings, meetings and endless meetings. My kids would fall asleep under the tables." Her son, Tonatiuh, now 22, "learned to walk and talk at meetings, being passed from arm to arm." The process, she says today, was something like community organizing when she was back in the university, going out into the countryside, asking what was needed, and talking with people about how to achieve their goals. It took several years, but a US Circuit Court ruled in favor of the refugees' cause in 1988, and the movement achieved temporary protection status in 1990, allowing Salvadorans facing persecution if deported to gain residential and employment rights in the United States. What was simple asylum for millions of anti-Castro Cubans was a much harder struggle for Salvadorans fleeing persecution from the right.
Other veterans of the US civil rights and anti-Vietnam movements formed groups like the Committee in Solidarity with the People of El Salvador (CISPES), which prompted the FBI to open a five-year investigation on some 2,000 individuals in 1,000 groups. Others formed Medical Aid to El Salvador to send medical supplies into the war zones. Also targeted by the Reagan administration was the North American Committee on Latin America (NACLA), an anti-imperialist think tank that grew from the 1960s.
According to the historian Walter Le Feber, "not a single shred of wrongdoing on CISPES' part could be shown." But the goal, according to an internal FBI memo, was to "formulate some plan of attack against CISPES and specifically against individuals who definitely display their contempt for the US government by making speeches and propagandizing their cause." According to Le Feber, over 60,000 Americans signed a pledge in the mid-eighties to commit civil disobedience if the United States invaded Nicaragua.
It was a moment of simmering public antiwar sentiment that the national security elites deeply feared. The sentiment even was reaching into the American religious hierarchy. The Robert F. Kennedy family became engaged with Salvadoran women's groups. Congress, still influenced by the Vietnam experience, began asking questions and formulating proposals to cut military aid. Even the ambassador to El Salvador, Robert White, began speaking out against the atrocities. Marjorie Tabankin, now a top Democratic progressive, who worked for the Arca Foundation at the time, began organizing trips to refugee camps on the Salvadoran border with actor-activists like Mike Farrell, among many others. Deeply struck by liberation theology priests she encountered, she traveled to El Salvador with delegations five times, spending eight years on solidarity work through the foundation she directed. An offshoot of that work was grassroots pressure in numerous congressional districts to stop military aid, as well as dialogue with Beltway opinion leaders.
"The Salvadorans then had two amazing qualities, a driving individual spirit and a grace and joy about their whole personalities," despite all the carnage, Tabankin recalls. "But the killing of the nuns (in December 1980) made it an American issue," she believes. And Congress in those times, she adds, was far more progressive and activist than the current Democratic majority when confronted with evidence of US-backed death squads.
At the time, Pentagon strategists still viewed El Salvador as "an experiment, an attempt to reverse the record of American failure in waging small wars, an effort to defeat an insurgency by providing training and material support without committing American troops to combat." On the home front, however, a majority of Americans were souring on the Central American counterinsurgencies, and were flatly against sending American ground troops. The US was forced to accept a negotiated peace accord in 1992, having failed to defeat the FMLN after spending $6 billion and contributing to 90,000 deaths over a twelve-year war. Besides that failure on the battlefield, it had become idiotic to accuse the FMLN of being agents of a Soviet Union which no longer existed.
Espinoza said he shows Michael Moore's movie Sicko--chuckling and savoring the pronunciation of the word--to his medical students as the best overview of the current crisis.
Of the four main distributors of medicines, those who broker between manufacturers, hospitals and pharmacies, three are owned by a cousin of the outgoing president, Antonio Saca, and the other by the family of a former president, Alfredo Cristiani. It gets worse: sometimes the system purchases medicines, including cancer and HIV medications, just before they expire and can no longer be given to patients.
Funding for increased access therefore will have to come from wringing efficiencies out of a system in which power is both bloated and maldistributed, a very difficult task. CAFTA worsens the crisis by extending patents, fostering market prices and "not considering healthcare a human right but a service." There still is room for negotiations over CAFTA, according to Espinoza, but it's a long way to his dream of a national healthcare system for Central America as a whole. As a leader of the recent battles against further privatization, he believes a greater social movement will be necessary "to address the social determinants of health." As for the public, he says it wants "total" and "radical reform" in the direction of universal care, and that its voice will be heard.
The role of solidarity movements
They came on foot, or often in the trunks of cars, separated violently from their families, often in the hands of uncaring coyotes who took the little money they carried. One-tenth of the Salvadoran people became war refugees living in Los Angeles alone. "The solidarity movement had a huge role in this victory," Linares reflects. "Our dreams are the dreams of the solidarity movement."
It is important to remember this movement in its many forgotten strands, for its tenacity, variety, duration and lasting effects. Refugees, most of them undocumented, beginning without material resources, eventually formed service and advocacy organizations such as the Central American Resource Center (CARACEN) El Rescate (the Rescue) and the Salvadoran-American Leadership and Education Fund (SALEF), which became extremely influential.
Carlos Hernandez Vaquerano is the leader of SALEF, which has provided hundreds of scholarships to Salvadoran youth and carried on voter education campaigns. He was in El Salvador with a delegation of longtime allies. His seemingly exceptional profile is like many others. He was born in El Salvador in 1960, and three of his brothers--Marciel, Numan and Osmini--were kidnapped, murdered or disappeared by death squads in the 1980s. Encouraged by his family to leave before he himself was killed, Carlos made his way to Mexico in October 1980 and crossed the Tijuana border while lying face down on an engine block under the hood of a GMC truck. He was 20 years old, leaving behind a mother and several siblings. His father died of alcoholism when Carlos was 4.
He immediately joined the Los Angeles branch of the FMLN, whose offices were on Bonnie Brae street adjacent to MacArthur Park, as a volunteer, supporting himself as a day laborer and factory worker. On Sunday mornings he and his friends made and sold tamales door-to-door to raise money for El Salvador, handing out political leaflets at the same time. Soon he began working with the sanctuary movement, a vast underground railroad established mainly by religious organizations to shield and harbor escaping Salvadoran and other Central American refugees. More than 300 churches and synagogues nationally declared themselves safe havens, and at least 100,000 Americans signed pledges of active support. After years of solidarity work, he went on to lead SALEF, and became a prominent supporter of the Funes campaign.
Another exile was Rosanna Perez, who came to the United States in the 1980s after the authorities repressed the university student movement, disappeared her husband, and kidnapped and tortured her in prison for two years. She crossed the border on foot; her daughter, Sara, 2 years old, was being smuggled ahead. For years afterward, the daughter dreamed about hiding Rosanna in a closed room while a man was trying to abduct her; only many years later, when she was a UCLA student, did Sara call Rosanna to ask what happened. Both started crying.
Once in LA, Rosanna adopted the alias "Sara Martínez," and began working with the Comite Santana Chirino Amaya, named after a Salvadoran deportee who was tortured and killed, and also with El Rescate and a clinic named for Monsignor Romero. At first she thought the war would end in a couple of years and she could return home. Instead, she found herself joining the sanctuary movement, learning English, and speaking before audiences of ignorant but sympathetic church-goers. "Believe me, those were days of meetings, meetings and endless meetings. My kids would fall asleep under the tables." Her son, Tonatiuh, now 22, "learned to walk and talk at meetings, being passed from arm to arm." The process, she says today, was something like community organizing when she was back in the university, going out into the countryside, asking what was needed, and talking with people about how to achieve their goals. It took several years, but a US Circuit Court ruled in favor of the refugees' cause in 1988, and the movement achieved temporary protection status in 1990, allowing Salvadorans facing persecution if deported to gain residential and employment rights in the United States. What was simple asylum for millions of anti-Castro Cubans was a much harder struggle for Salvadorans fleeing persecution from the right.
Other veterans of the US civil rights and anti-Vietnam movements formed groups like the Committee in Solidarity with the People of El Salvador (CISPES), which prompted the FBI to open a five-year investigation on some 2,000 individuals in 1,000 groups. Others formed Medical Aid to El Salvador to send medical supplies into the war zones. Also targeted by the Reagan administration was the North American Committee on Latin America (NACLA), an anti-imperialist think tank that grew from the 1960s.
According to the historian Walter Le Feber, "not a single shred of wrongdoing on CISPES' part could be shown." But the goal, according to an internal FBI memo, was to "formulate some plan of attack against CISPES and specifically against individuals who definitely display their contempt for the US government by making speeches and propagandizing their cause." According to Le Feber, over 60,000 Americans signed a pledge in the mid-eighties to commit civil disobedience if the United States invaded Nicaragua.
It was a moment of simmering public antiwar sentiment that the national security elites deeply feared. The sentiment even was reaching into the American religious hierarchy. The Robert F. Kennedy family became engaged with Salvadoran women's groups. Congress, still influenced by the Vietnam experience, began asking questions and formulating proposals to cut military aid. Even the ambassador to El Salvador, Robert White, began speaking out against the atrocities. Marjorie Tabankin, now a top Democratic progressive, who worked for the Arca Foundation at the time, began organizing trips to refugee camps on the Salvadoran border with actor-activists like Mike Farrell, among many others. Deeply struck by liberation theology priests she encountered, she traveled to El Salvador with delegations five times, spending eight years on solidarity work through the foundation she directed. An offshoot of that work was grassroots pressure in numerous congressional districts to stop military aid, as well as dialogue with Beltway opinion leaders.
"The Salvadorans then had two amazing qualities, a driving individual spirit and a grace and joy about their whole personalities," despite all the carnage, Tabankin recalls. "But the killing of the nuns (in December 1980) made it an American issue," she believes. And Congress in those times, she adds, was far more progressive and activist than the current Democratic majority when confronted with evidence of US-backed death squads.
At the time, Pentagon strategists still viewed El Salvador as "an experiment, an attempt to reverse the record of American failure in waging small wars, an effort to defeat an insurgency by providing training and material support without committing American troops to combat." On the home front, however, a majority of Americans were souring on the Central American counterinsurgencies, and were flatly against sending American ground troops. The US was forced to accept a negotiated peace accord in 1992, having failed to defeat the FMLN after spending $6 billion and contributing to 90,000 deaths over a twelve-year war. Besides that failure on the battlefield, it had become idiotic to accuse the FMLN of being agents of a Soviet Union which no longer existed.
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