When the worst hurricane in a century pummeled Central America in October, public-health specialists who had been working with Honduras to promote a new health-care system figured hopes for reform were dead.
But spurred by the calls of Central American leaders, including Honduran President Carlos Flores, to use the devastation left by the storm to transform the region, the country's health officials redoubled efforts. With some of the aid from international sources, officials are accelerating plans to replace a national program based on expensive hospitalization (that few qualified for) with emphasis on preventive care. Advocates of political, educational, and other reform also see the tragedy as an opportunity.
"When Mitch hit we thought [Hondurans] would just sink back into repairing what they already had, but they are trying to rethink and reform," says Elena Brineman, Honduras director of USAID, the US foreign aid program. "In that sense, Mitch has done us a favor."
In every other sense, it was an unmitigated disaster. The hurricane dumped a year's worth of rain over much of Honduras and Nicaragua and parts of Guatemala and El Salvador in less than a week, killing more than 8,500 people, leaving more than 1 million Central Americans homeless, and destroying more than $5 billion worth of economically vital infrastructure.
Across one of the poorest and most underdeveloped regions of the Western Hemisphere, Central Americans are responding to the tragedy with a determination to transform. Although some officials and relief and humanitarian workers in the region caution that inertia and habit still threaten to win the day over a more complex process of change, signs of a budding transformation are visible eight months after the storm:
*Democracy: Building on democratic reforms taking hold in the region after decades of dictatorship and armed conflict, dozens of grass-roots community organizations have sprung up or strengthened in response to demands for post-storm cleanup, housing, and economic revival.
"Our reconstruction plan is based on the involvement of all the elements of our expanding civil society, from development organizations to the private sector, and not just the government," says Nicaraguan Foreign Minister Eduardo Montealegre.
*Transparency: Mindful of the long-term political implications of widespread corruption in relief efforts following the Managua earthquake of 1972 and Hurricane Fifi in Honduras in 1974, national leaders acted quickly to keep emergency and assistance programs clean and equitable.
After Mitch, Honduras passed new legislation for more open government contracting. Despite some complaints of pocket-lining and favoritism, international observers say the relief effort demonstrates progress.
*Decentralization: With many parts of hard-hit countries isolated for days after Mitch, local governments were often the only lifeline for many residents. The long-term effect should be a strengthening of the role of municipalities, experts say.
*Disaster response: Countries are working on early-warning systems to avoid a repeat of the "surprise" of an erratic storm like Mitch, while emergency response programs are being revamped.
*Environment: Perhaps the most difficult area in which to promote change because of people's traditional land-use patterns, but there is a growing awakening to the link between environmental degradation and a hurricane's high life and property losses. El Salvador is emphasizing watershed protection in its rebuilding plan; Honduras has banned construction in natural water courses.
*Education: Countries are using Mitch to jump-start education reform. Nicaragua plans a revamp under which education in rural areas will be designed to make sense to rural populations and respond to rural-life social and economic needs.
Much of Central America's hope of transformation lies in the unprecedented international assistance effort that Mitch spawned. After the initial focus the world placed on Central America in the weeks following the storm, officials had worried that interest might subside.
The war in Kosovo augmented those fears. But an international conference of donor countries held in Stockholm in May proved the concerns largely unwarranted. Donor countries and international financing institutions have either spent or committed more than $5.3 billion in Central America since Mitch, according to the Inter-American Development Bank, which chaired the Stockholm meeting.
Some of that money was already earmarked foreign-aid money that has been redirected to better fit the countries' transformation plans. But in other cases it's new money.
International debt relief is one of the central factors that will determine the success of Central America's transformation effort, analysts say.
The G-7 group of most industrialized nations is considering including Honduras and Nicaragua in a debt relief program for the world's most impoverished countries. Money freed up from debt payment would be required to go toward social programs like education.
"They'd be paying tens of millions of dollars less every year on their debt, which means tens of millions more for development," says one Western diplomat.
Payback, not handout
Some analysts emphasize that international assistance to Central America should not be seen as a handout, but more as payback for the damage world powers have caused in the region both in past ideological conflicts and in exacerbating global environmental trends.
Speaking recently in Costa Rica at an international disaster-prevention-and-response conference, Jeffrey Sachs, noted economist with Harvard University in Cambridge, Mass., said the international community's post-Mitch effort should be seen as compensation.
Heavily industrialized countries, with their development model and intense energy use, are at least partly responsible for the heavier damage that environmental changes - including stronger hurricanes - are causing.
In Central America, officials and citizens express gratitude for the international assistance, but there is also recognition that hopes of transformation will remain empty if the region doesn't pull itself up.
"We are receiving a lot of aid, and we are very appreciative of that, but this has to be done by Hondurans or it won't really be change," says Juan Alberto Lara Bueso, general secretary for international cooperation at the Honduran Foreign Ministry.
"The ideal from the government's perspective is that we achieve a change in thinking," he adds. "I can't tell you we've done that, but there is a process of awareness that's advancing."
Mr. Lara says more people are convinced - after tens of thousands were left homeless by raging waters - that natural waterways must be respected.
Local action is one example of changed thinking among people who traditionally approached natural events fatalistically. "They realized no one was going to come and do things for them, and that in turn created a whole new scenario of people realizing they could do something themselves," says USAID's Ms. Brineman.
Still, continuing government resistance to too much decentralization is one factor that holds back local initiative. Honduras in 1991 passed a law directing the central government to send 5 percent of national revenues to the municipalities, but this year less than 2 percent of revenues is earmarked for local governments.
The same is true in Nicaragua, although Guatemala and Costa Rica have more advanced decentralization. Guatemala sends 10 percent of the national budget to municipalities.
"The government has given lip service to decentralization, but it's not really advancing, so we are making a concerted effort to strengthen municipalities," says Fernando Mudarra Ruiz, coordinator of Spain's international cooperation program in Honduras.
Expecting better services
According to Mr. Mudarra, one of the determining factors in the success of Central America's transformation will be the size, training, and technical preparedness of the corps of local experts who will manage the reconstruction effort over the coming years.
"Basically I see ministries with very little expertise and very little capacity to carry out the plans being talked about."
Others like USAID's Brineman agree that creation of something like a civil-service corps will be important. "I've seen a lot of examples ... of communities organizing for the first time to build everybody a house," says Brineman. "Once you've organized to build houses, you know how to organize to demand the water service you want, the sewage you want, and the school you want."