Central America's Health Plight

Disease and malnutrition plague war-ravaged Central American states

THE victory of Mrs. Violeta Barrios de Chamorro's opposition coalition in Nicaragua and the recent proposal of the Salvadoran guerrillas to reinitiate negotiations with the government offer a unique opportunity to redress United States policies with regard to all Central American countries. One very needed step is to rebuild the destroyed health infrastructure in the region. A change in US policy toward cooperation would give reason for hope to the desperate Central American people.

More than a decade of strife has led to a steady deterioration of health and living standards in the region, a situation I witnessed during several health-related missions to the area. Malnutrition is widespread, and infant mortality rates continue to be among the highest in the continent.

According to Pan American Health Organization estimates, of 850,000 children born every year in Central America, more than 100,000 will be low birth-weight babies, and 100,000 will die before they are five years old. Almost two-thirds of those who survive will have some degree of malnutrition, which will lead in many cases to serious physical or mental development problems.

The incidence of malaria has increased due to the disruption of malaria-eradication campaigns in war zones. In other cases, disruption of immunization campaigns has led to serious outbreaks of measles.

Massive population displacements have led to increased nutrition problems, especially among children below five.

In El Salvador, more than 10 years of conflict has led to the uprooting of more than one million people (the total population is 5,389,000, according to 1988 figures).

Data from the Fundaci'on Salvadorena de Desarrollo y Vivienda M'inima (FUNDASAL) show that recent refugees found 40 percent of their homes totally destroyed, and an additional 25 percent were in need of major repairs.

As a result of the war hundreds of thousands of civilians were killed or maimed, and many children became orphans - an estimated 100,000 in Guatemala alone. To make matters worse, hundreds of medical facilities have been totally or partially destroyed. They range from health posts in rural areas to more complex facilities in towns and cities.

This situation has been aggravated by the presence of foreign troops in the region. Dr. Juan Almendares, a Honduran medical scientist and former rector of Honduras National Autonomous University, states that the presence of foreign soldiers in Honduras has created or exacerbated some serious health problems. To escape poverty thousands of Honduran girls have become prostitutes, which has led to a marked increase in sexually transmitted diseases.

The new developments in the region could help initiate a new trend. The US could make a significant contribution to improve the health and well-being of the Central American people.

By rechanneling funds that up to now have been used mostly for military purposes, the US could, through international agencies with experience in the region (Pan American Health Organization, UNICEF, nongovernmental organizations among others), set in motion a series of actions geared at rebuilding the destroyed health infrastructure in the Central American countries.

This could be accompanied by policies to speed up economic recovery in the area. They include providing emergency debt relief, giving technical and financial support to modernize production, and assuring stable access to Central American exports.

The US and other industrialized nations could also collaborate by removing agricultural subsidies that negatively affect trade opportunities for developing countries.

These actions would help change the present climate of antagonism and war into one of cooperation and stable peace. By implementing policies geared to help the Central American people lead better lives the US would allow them a dignity of living that they have been missing for too long.

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