el monsiour

http://www.independent.com/cover/Cover968.htm


by George Thurlow
SANTA BARBARA INDEPENDENT
Thu, 09 Jun 2005 5:10 PM PDT

El Salvador, April 2005. When our hired driver, Che, delivered Dr.
Bill Morton-Smith and me into the gang-infested La Chacra
neighborhood of San Salvador, he took the "nonviolent route." La
Chacra is the dividing ground between two local gangs, including the
notorious Salvatrucha M-13, located on the cincherón de miseria, or
belt of misery, surrounding San Salvador's bustling urban capital.
Last time they came, Morton-Smith told me, they had driven past a
woman savagely beating a man on the head with a rock. In the belt of
misery, explained Che, you don't stop your car for anything, not
until you are safely inside the fenced parish compound of Maria Madre
de los Pobres.

As a representative of Santa Barbara-based Direct Relief
International (DRI), Morton-Smith's mission was to determine whether
the medical clinic run by the Catholic Church at La Chacra could
handle a massive increase in donated medicines from DRI. My own
mission was to drop off a 30-pound duffel bag filled with the
antibiotic Lorabid at the La Chacra clinic, where the shelves were
bare of any antibiotics.

La Chacra is a crowded slum of wood and brick huts spilling down the
steep slopes into the [Acelhuate] River, a stream so polluted that
mounds of trash sit on its many little islands. Rather than gurgling,
the river foams. Residents bathe and swim in the muck, drink from
even more polluted water sources, and are wracked with upper
respiratory problems brought on by poor nutrition, crowded living,
and polluted air. One major medical debate here is how soon to treat
somebody suffering a routine, but serious, case of worms. Realizing
that the afflicted will quickly re-ingest the parasites from either
the dirt or the water, do you treat them immediately, or wait until
their body is teeming with parasites? Medical ethics are weighed
daily against limited supplies of medicine.

Over the next week, I would follow Morton-Smith - DRI's finger in
the proverbial dike of disease and death - as he crisscrossed Central
America, assessing how best to get huge supplies of medicines from
generous pharmaceutical companies in the United States to far-flung
clinics everywhere from the northern borders of Honduras to the
beautiful shores of Lake Atitlan, Guatemala. Our paths would cross
that of U.S. Secretary of State Condoleezza Rice, herself on a
mission - though she traveled at a different altitude.

BELT OF MISERY

Once inside the parish courtyard, we sat around a table sipping fresh-
squeezed orange juice and talked with Father Daniel Sanchez, a
Spanish-born priest who has ministered to this community since the
1980s. Sanchez told us that more than 4,000 people from 18
surrounding neighborhoods - gang violence notwithstanding - relied on
the clinic at Madre Maria. The conversation quickly turned to the
contents of my duffel bag, and to antibiotics.

"Ninety percent of the world wants amoxicillin," said Morton-Smith.

The parish clinic was no different. Even though their shelves were
empty of any antibiotics, Madre Maria's staff members had their
doubts about the Lorabid we brought. The problem, Morton-Smith
explained, is that while more powerful antibiotics like Lorabid are
donated to DRI, the drug companies are reluctant to part with
amoxicillin. The reason is purely an economic Catch-22. Because
amoxicillin is a hot seller throughout the world, the drug companies
don't want to compete with their own sales chains, and no matter the
cost or availability, healthcare workers in the regions where
amoxicillin is needed most have come to rely on it more and more.

Diseases rarely seen in Santa Barbara are rampant in El Salvador.
Polluted drinking water is common, as is diarrhea caused by
salmonella and E. coli bacteria; upper respiratory tract infections
resulting from poor diet and air pollution are the norm. According to
the World Health Organization, the death rate for intestinal diseases
among infants under one year of age is 25 per 100,000 in the States,
compared to 660 per 100,000 in El Salvador.

Still, bringing Lorabid into the disease-ravaged environment of La
Chacra had its risks.

"The bugs in La Chacra are going to become resistant to Lorabid,
because that's all they'll have here," Morton-Smith warned.

Father Sanchez, who in the '80s was forced to flee to the countryside
because of death threats he received from military-supported death
squads, said that while he worried about polluted drinking water, the
scarcity of amoxicillin, gang violence, and the raging crack cocaine
problem, what troubled him most is the big picture of El Salvador's
economy.

"The situation is at its worst now," he said, explaining that the
average worker in La Chacra earns $100 a month, mostly by vending
fruit or gum on the streets of downtown San Salvador. Unemployment is
high - 50 percent, by some estimates - and underemployment is
common. "The economy is going down and the poverty is going up,"
lamented Sanchez. In nearby Nicaragua, there had been riots in the
streets the week before, as student protests against bus fare hikes
and rising gasoline prices flared into violent demonstrations against
the conservative government. "What happened there, could happen
here," Father Sanchez warned.

The region as a whole appears near a tipping point. The president of
Ecuador was removed from office earlier this year by that country's
Congress in the face of a mounting economic crisis. Street protests
have brought Bolivia to an economic and political standstill, while
labor strikes in Peru threaten to bring down the government. In
Uruguay, Brazil, Chile, and Venezuela, socialists who are critical of
the U.S. have been popularly elected to lead their countries. In
Colombia, ongoing civil upheaval related to the narcotics trade
requires the U.S. to pour billions in aid to keep the government
propped up.

And after 10 years of neoconservative economic policies throughout
Latin America - privatizing government utilities, cutting social
programs, allowing basic food prices to rise, and opening the doors
to foreign investors - the people of La Chacra were no better off,
and there are more of them.

WORLDS APART

Two days later, Condoleezza Rice told the Salvadoran press corps
gathered at the sprawling Casa Presidential - the local equivalent of
the White House - that another decade of more of the same would be
good for all of Latin America. Rice had arrived at the presidential
estate well past dark, cruising in a motorcade complete with security
SUVs and an ambulance roaring alongside. She had no doubt missed the
campesinos trudging down the road; she didn't see the scores of women
standing outside the clothing factories that are shutting down and
moving to China. And she probably never rolled down her window to
breathe the choking dust and smog of the poor capital.

Later, in front of the Salvadoran media and a small handful of U.S.
reporters traveling with her, Secretary Rice called El Salvador - the
only Latin American country to send support troops to Iraq - "one of
our strongest allies in the hemisphere, an ally that we admire as a
strong fighter in the global war on terror and, a country that,
having known terrorism itself, is willing to stand up and fight it."

Terrorism, of course, is defined in the eye of the beholder, and it
doesn't hurt to remember that for the past 60 years, the U.S. has
exercised secret and not-so-secret gunboat diplomacy in Central
America with varying degrees of success. In 1954, the CIA engineered
a coup against Jacobo Arbenz, the elected ruler of Guatemala, leading
to more than 30 years of bloody civil war. In 1983, the Reagan
administration openly aided Manuel Noriega's rise to power in Panama,
then removed him in 1989 with a short, bloody Christmas invasion. In
1986, the World Court called on the U.S. to "cease and to refrain"
from unlawful use of force against Nicaragua through its training,
funding, and support of the terrorist forces, otherwise known as the
Contras. The court ruled that the U.S. was "in breach of its
obligation under customary international law not to use force against
another state" and was ordered to pay reparations. The American
response to this ruling was to dismiss the jurisdiction of the court
and step up its aid to the Contras.

In El Salvador, the Reagan/Bush administrations spent billions
between 1980-92 aiding a military dictatorship in its war against a
popular uprising. Death squads operating with the approval of the
U.S. and the Salvadoran government murdered or "disappeared" an
estimated 30,000 civilians and guerilla fighters, including
Archbishop Oscar Romero. More than seventy thousand El Salvadorans were
killed in all.

American covert operations in Central America, particularly during
the Reagan/Bush years, were largely motivated by the Cold War idea
that the Soviets were intent on establishing beachheads in the
region. Since the fall of the Soviet Union, however, and the rise of
NAFTA - the free trade agreement between Canada, U.S., and Mexico
established in 1994 - American interests, when we care to pay
attention to the region, have shifted to economics. In her remarks to
the Salvadoran press, Secretary Rice urged the passage of similar
free trade laws that would further open Central America to cheap U.S.
agricultural exports and corporate investment. Whether more free
trade would benefit El Salvador as much as it would the U.S. is
academic. The New York Times reported in April that while economic
growth in Latin America hit an impressive 5.5 percent in 2004, the
number of people living in poverty remained the same - a staggering
44 percent of the population of the region.


REMEMBER THE DISAPPEARED

The next day, already in Guatemal, we sped across the lake Amatlitlani
to Santiago, one of the major towns on the lake. Ferried by
three-wheeled cabs, we rode several miles to the outskirts of town
where a new hospital was emerging from
the rubble of what remained of the community clinic that shut down
during Guatemala's long civil war. Just down the road is a monument
to the 14 Santiagans who were gunned down by soldiers during a
protest in 1990. The hospital closed shortly after because residents
did not want to pass the military garrison situated next door to the
hospital.

Now, with the help of a handful of Americans, including husband and
wife physicians, the hospital was again open. Even before the
operating room was fully operational, patients came seeking help.
Morton-Smith asked a flurry of questions, seeking to determine if the
hospital - really just a large clinic that someday might have acute-
care beds - could handle large shipments of medical supplies from
Santa Barbara's DRI.

As we toured the hospital, we met Robert, a skilled craftsman from
Arkansas. He was building all the shelves and countertops to be used
in the clinic. In his other life, he installed custom fixtures for
Wal-Mart; in Santiago he was helping to rebuild a clinic.

Leaving, we piled into the back of a pickup that served as this
neighborhood's mass transit. I was feeling better about America, and
about Americans, and I wished Secretary Rice could have been here,
too.

On my last day in El Salvador, I asked Che to take me to El
Salvador's newest and largest war memorial. Located in Cuscatlan
Park, not far from where the war ravaged whole neighborhoods of San
Salvador, a series of black panels list the names of more than 25,000
civilians who were murdered or disappeared during the 12-year civil
war.

I wanted to find the name of my wartime driver, Gilberto Moran. In
April 1981, he was shot and killed by the Treasury Police, one of the
most notorious military arms of the U.S.-backed government. There
were 129 rows of names on each of the panels, with six or seven names
to each row. For 1981, under the heading "Homicidios," there were
more than 1,[300 names -an additional 600 civilians "disappeared"
that year alone. But Moran's name was not among them.

With the exception of a man collecting bottles for recycling, and a
longhaired student, no one else came to the memorial in the half hour
Che and I stood looking at the names. It wasn't surprising that the
people of El Salvador wanted to forget the 70,000 dead - the heavy
toll of the United States' 12-year war against communism.

Americans are not much different. They have already forgotten.