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USA: Salvadoran Doctors Enlist Emigrants in Privatization Struggle

Washington Post
March 13th, 2003

Several doctors from El Salvador have been making the rounds in Washington the last couple weeks, stopping by Congress and the State Department but also visiting the centers of another significant power here--the Salvadoran immigrant community.

The doctors, who with their colleagues back home have been on strike since September against what they see as the Salvadoran government's attempt to privatize the public health system, seemed to know they would find a receptive audience among the immigrants. It is an audience to which words like "privatization," "trade liberalization" and other catch phrases of Washington policymakers conjure up as much suspicion and distrust as in communities across Latin America.

Today, the estimated half-million Salvadorans in Washington and its suburbs help supply nearly one of every five dollars of El Salvador's gross domestic product. At $2.2 billion a year, this vital economic link is the most obvious manifestation of a powerful bond between immigrants and their families and friends back home.

How ironic it is then that those who are the single largest source of income for El Salvador are so leery of the role played in that country by their own neighbors in Washington. They may live only blocks from Washington policymakers who oversee U.S. government activities and spending in El Salvador, but their views of the country and its future seem miles apart.

Ask almost anyone comfortably working inside imposing buildings of the World Bank or the State Department and the response will be a bright picture of El Salvador today. It has one of the best managed economies in the region, they would tell you, one that in a decade overcame the devastating political polarization of a civil war, and is now poised to develop even more through a free trade agreement with the United States.

Ask hard-working Salvadoran immigrants in non-official Washington, the second-largest Salvadoran community outside El Salvador (behind Los Angeles), and you are likely to hear a different story. To them, rosy macro economic indicators are mere numbers that don't translate into less poverty and better opportunities in the cities they came from such as San Salvador, Chirilagua and San Miguel.

This gap is worth bridging. Failing to do so may endanger future progress in a country where neoliberal reforms have succeeded, for instance, in increasing exports and restraining inflation, despite worsening prospects throughout the region.

Consider the fate of health reform, one of the most contentious and pressing issues today in the Central American nation of 6 million. Dr. Ricardo Cea said in an interview this week that the current health reform "conflict" threatens to take the country again into a "state of war" as it was in the late 1970's. His message found a receptive audience among immigrants in this country who, concerned that more of their dollars would be needed to cover more expensive health services, have begun to rally against privatization.

For its part, the Salvadoran government insists that privatization is not an issue and it does not intend to dismantle the deeply distressed public health care system. Regardless, its reform has become an ideological battle that is being further politicized just days before Sunday's scheduled mid-term elections. To the strikers and many in the opposition, the vote will be a referendum on U.S.-promoted policies adopted by the conservative government.

There is no doubt that the result of the weekend's polling will shape the way health reforms and others are debated and enacted. And while the ruling ARENA party may be thankful that Salvadorans abroad cannot vote, it knows well that, even if it wins, it can't ignore the impact that immigrants have on friends and family who can.

Until now Salvadoran immigrants have had a good working relationship with the current government back home. That relationship could now be extended to respond to an even greater challenge. Today, many Latin American governments must show that their cooperation with Washington is not incompatible with wider social agendas. An important boost to that effort could come if Salvadoran immigrants' perceptions of official Washington's intentions are changed and the divide between the two narrowed.

Besides, consider the added benefit: A community with increased confidence in the Salvadoran political system some day may even become the rare but sorely needed ``foreign'' private investor with a social conscience.





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