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COVID-19 and Central America: a Learning Moment?

by  James Phillips, Ph.d., a cultural anthropologist at Southern Oregon University. His book, Honduras in Dangerous Times: Resistance and Resilience, was published by Lexington Books in 2015.

 

The countries of Central America are indeed central to the foreign and domestic policies of the United States in many ways, most obvious of which is immigration. But the current COVID19 pandemic has exposed significant differences in the responses of Central American countries and examples of gross disaster opportunism and the double standard applied to different countries. Compare two neighbors—Honduras and Nicaragua. The difference between these countries is stark. According to figures from the Sistema de la Integración Centroamericana (SICA)—figures that the World Health Organization considers reliable—as of April 10 Central America as a whole had over six thousand confirmed cases of COVID19. Honduras had 385 confirmed cases in a total population of about 9.5 million. Other sources reported an increase in cases the next day. Nicaragua had 8 total confirmed cases, including 4 active, 1 death, and 3 recovered, out of a population of 6.7 million, the second lowest number of cases in Central America, after sparsely populated and much smaller Belize, but by April 14, Belize had surpassed Nicaragua in number of cases. By April 19, the date of this writing, Honduras had nearly 500 confirmed cases; Nicaragua, 10. Some have attributed the low number of cases in Nicaragua to a very low testing rate, but the same concern has been voiced about Honduras where some think the actual rate of infection is much higher than detected.

Honduras

Soon after the first confirmed cases of COVID19 appeared in Honduras, the government of Juan Orlando Hernandez ordered the country’s borders closed and instituted a state of  emergency, basically imposing martial law. An all-day (24 hour) curfew was imposed so people could not leave their homes for any reason, on penalty of being arrested by the police or detained by the military. Supermarkets were closed. When this became obviously unsustainable—people would starve in their homes—the government allowed a short window of a few hours each day during which people could shop at local grocery stores, pharmacies, and banks. The result was predictable, the opposite of social distancing, as
lines of people flocked to shop within the narrow time allowed. The government then initiated a system in which people were allowed to leave their homes for a couple of hours on one day of the week, depending on the last digit of their national ID number.

In recent days in various cities and towns, street protests for food were repressed by the police and military with tear gas. Meanwhile, Honduran military units, in full protective gear, were free to enter the supermarkets at any time. The military had the urban food supply largely in its hands. Military units also patrolled the streets and roads, arresting anyone who violated the curfew. If you were trying to take your ailing grandmother to the hospital, or to buy a little food, you could be arrested and detained in jail. As of April 10, some reports claim that as many as six thousand people have been arrested for violating the curfew. There have also been reports from Honduran human rights leaders that the government has taken the opportunity also to detain some opposition and human rights activists. The situation of the people is made worse because of the unreliability of the privatized electric grid and the drought that demands rationing of water in Tegucigalpa, the capital, a city of more than one million.

In some cities, especially Tegucigalpa, street chldren face an even worse situation being exposed without homes and also subject to police and military arrest for violating the stay-at-home restrictions. There are also reports that families are being evicted from their apartments because they cannot pay rents as businesses are shut and employees are unable to depend on paychecks or even daily informal work. In the countryside, local small farmers are finding it difficult to get to their fields to cultivate. They are stopped at military roadblocks designed to restrict the flow of traffic and enforce shelter-in-place restrictions. Local small food producers cannot feed their families.

Although all of this is bad enough for Hondurans who have regular employment or plots of land and must now remain home, the impact of the virus and the martial law measures are disastrous for the many Hondurans without formal employment who survive in the so-called “informal economy.” Accurate figures are hard to come by, but it is likely that at least forty—and by some accounts up to seventy percent—of the population  in cities is engaged in this informal economy of survival. These are the street vendors, the women on street corners each morning selling fresh tortillas, the folks who stand in the middle of busy streets or at stop lights selling all kinds of products that they have bought in small quantities or made themselves at home out of “junk” that society throws away, and the folks who sell fast food or shine shows on the sidewalks, and the men who go out each day looking for someone to hire them for the day. These are the people who really live meal to meal on the edge of survival. The human and vehicle traffic they depend on has almost disappeared with the imposition of the state of emergency, and they themselves are subject to arrest and brutal treatment by police and military if they venture out. They are the most marginal of people, the most vulnerable in bad economic and political times, the people whose services are often considered useful to some but essential to other poor people. They themselves, however, are often seen by authorities as a nuisance in the best of times.

Perhaps the worst blow to Hondurans at this time is that the Honduran public health system had already collapsed long before COVID19 appeared in China. The Hernandez government and the Congress controlled by his National Party had spent the preceding few years looting the public health budget to fund the militarization of the country and the re-election campaign coffers of Hernandez and the National Party. They also raided and reduced the public education budget, and announced that both health and education should be privatized. All of this provoked a massive protest movement headed by the president of the College of Physicians, Dr. Suyapa Figueroa. Last year, Figueroa warned repeatedly that the ruined public health system could not cope adequately with the epidemic of dengue fever ravaging most of Central America. Honduras had some of the highest numbers of deaths from dengue in the region.

Berta Oliva, director of the Committee of the Families of the Detained/Disappeared in Honduras (COFADEH), a major human rights organization, and other human rights leaders have accused the government and the military of using the pandemic as an opportunity to tighten control of the population through fomenting fear of the virus and imposing draconian state-of-siege measures. Keeping people in a precarious state serves the interests of a government that many Hondurans call a “dictatorship.”  Suspicions about the true intent of the government’s measures is increased by the realization that many of these measures make little sense and are actually counterproductive if the goal is to reduce the spread of the virus. The Honduran Congress has set aside the equivalent of three billion (US) dollars to fight the pandemic, but observers are wary that most of this will line the pockets of a few politicians and military commanders. Honduran economic watchdog organizations are already asking why so little of this money has actually been spent to fight the pandemic. The concern is well-grounded in Honduras where official corruption is rampant and transparency is almost non-existent.

The measures imposed by the government to contain the virus are also making the work of human rights and independent investigative journalism that much harder. In Honduras, such work is difficult and dangerous anytime. Now the government imposed immobility has made the work of  investigation, collection of information, and advocacy for victims so much more difficult and dangerous. Despite this, courageous human rights staff and independent journalists in organizations like COFADEH and Radio Progreso continue to investigate and report. It becomes harder to tell the international community what is happening in Honduras. In recent days, the director of Radio Progreso, Jesuit Father Ismael Moreno (Padre Melo) and his staff have seen a stream of anonymous social media messages that remind President Hernandez that he knows how to deal with these “leftists” at Radio Progreso. Such not-so-veiled threats are not new, but they come again at this particularly vulnerable time. Beyond this, the inability of foreign solidarity delegations and international human rights accompaniment to travel to and enter Honduras has left few international observers to monitor human rights abuses and repression in the country. The government and the corrupt can always claim that these measures are necessary to fight the pandemic, while taking advantage of their undermining effect on human rights and solidarity work.

Perhaps the only silver lining in this situation is the report that the massive and widespread systems of extortion of businesses, families, and individuals by the Honduran gangs that control whole neighborhoods of the cities is also temporarily slowed by fear of the virus.  All of this is happening in a country where the official poverty rate is hovering around 68 percent, with “extreme poverty” around 40 percent, according to both Honduran and international organizations—some of the highest indices of poverty in the Western Hemisphere. The large majority of Hondurans have scant means of physical or economic survival in better times when there is no pandemic. How much worse now?

Nicaragua

Nicaragua shares a long border with Honduras, much of it through very rugged country. In 1979, the Sandinista Front (FSLN) led a popular revolution that overthrew the 45-year dictatorship of the Somoza family that had enjoyed the full support of U.S. Administrations going back to FDR. Since then, from Reagan to Obama to Trump, U.S. Administrations have fomented or supported any and all efforts to discredit, defeat, and eliminate the influence of the Sandinistas and President Daniel Ortega.

As of April 7, Nicaragua reported six cases of COVID19, and by April 10 it was 8 cases. All of these cases were traced to arrivals into the country from abroad. Nicaragua has been screening all arrivals at its one international airport in Managua. The government has not closed its borders, but has relied on screening instead. One reason given for this policy is that it might reduce the incentive for people to enter outside of regular checkpoints where they can be screened for the virus. The government has not issued shelter-at-home orders or imposed a curfew. People continue to go to work, school, or even religious services (although some churches and the Catholic hierarchy have ordered suspension of
services).

According to Jorge Jenkins, a cell biologist and former representative of the World Health Organization (WHO) and the PanAmerican Health Organization (PAHO), there are several biocultural reasons that might help explain the currently low incidence rate of COVID19 in Nicaragua. These include: lack of lab testing to detect cases; cases going undetected due to mild symptoms while more serious cases may emerge later; low number of international travelers arriving in Nicaragua, especially compared to Costa Rica and Panama, both countries with much higher numbers of cases; a young population that is less vulnerable to the virus; low population density; a relatively large rural population that lives in areas where risk of contracting the virus is lower; the virus is hitting at the country’s hottest season when such infections tend to be lower; housing tends to be individual and spread out.

Jenkins acknowledges that all of these are conjectures, not proven reasons. Some of the characteristics he mentions are true also, to some extent, for other Central American countries. Time will tell. But he also mentions another factor that might be relevant. In contrast to Honduras with its collapsed health care system,

Nicaragua has wonderful specialists in public health and epidemiology and an advanced school for it, the CIES, with a strong and well-deserved international reputation that has trained several generations of distinguished health professionals. Also prominent in the country are the opinions of other health professionals with extensive experience, including intensive care doctors, infectious disease specialists, pulmonologists, cardiologists, anesthesiologists, and other professionals with the skills to care for COVID-19 patients.

In addition, Nicaragua has a system of grass-roots public health clinics, supported by the Ministry of Health, that are a legacy of the revolutionary government of the 1980s. Nicaragua is working with and is following guidelines established by the World Health Organization (WHO) and the PanAmerican Health Organization (PAHO).  The country has,

…. a public health system which offers free, universal health services based on community-focused preventative care. The measures put in place include an extensive programme of over 2.3 million home visits to raise awareness of the symptoms and impact of the pandemic, preparing and training over 35,000 medical staff and 250,000 volunteer health promoters, ensuring that 19 hospitals around the country have the necessary equipment to treat patients, meticulous screening arrivals at land borders and airports by checking their temperatures, rigorous follow up of people returning from countries where the virus is widespread, intensive prevention and education campaigns and a national helpline for those needing advice and emergency support.

In Honduras, no such comprehensive grass-roots  system is functioning. The Nicaraguan government’s open but monitored approach is in stark contrast to the tightly closed and controlled policy of Honduras and, to some extent, most other Central American countries. While other Central American governments have tended to adopt standard policies that mirror practices in wealthier countries, Nicaragua has tried to tailor its responses to the practical cultural and social realities of its people. Like Hondurans, Nicaraguans are a people who live in relative close community, where only a very small number of people have jobs they can engage online. As a longtime resident of Nicaragua has pointed out, few people there have access to technologies or jobs that would allow them to work from home. People depend on work outside in interaction with others or on selling in markets in order to be able to eat and feed their families. There are practical social and cultural realities to take into account on a scale that encompasses a much larger portion of the nation’s population than in most wealthy countries.

Unlike Honduras, the Nicaraguan government has forged its own policies seemingly tailored more closely to the practical realities of its own people. Time may tell which approach is more effective in curbing COVID19. Nicaraguan authorities say that they will implement more restrictive measures if and when they become necessary. In any case, the Nicaraguan government cannot reasonably  be accused of the same kind of gross political and economic opportunism as the Honduran government, or an unthinking disregard for the well being of its people.

Criticisms of Nicaraguas Response

The Nicaraguan government has been the object of criticism for the way in which it has dealt with the COVID 19 pandemic. The Lancet, a respected British medical journal,  has accused the Nicaraguan government of recklessly endangering the lives of its people by not strictly enforcing social distancing or closing meetings. The Lancet article also claims that Nicaragua is the poorest country in Central America. That statement says nothing about how the wealth ands poverty is shared. Honduras has a higher gross domestic product, but it also has one of the greatest disparities of wealth and poverty in the hemisphere, and its poverty rates are more that twice those of Nicaragua. The Lancet articlefails to mention that the number of COVID19 cases in Nicaragua is many times smaller than in Honduras where draconian control measures are in place. In fact, the Lancet article does not mention Honduras at all, and so fails to ask if, perhaps in this case, the results justify the means.

An article in The Guardian rehearses more accusations against Ortega and the Nicaraguan government. A New York Times article with a Nicaraguan by-line implies that the Nicaraguan government is using the pandemic as an excuse to hold public demonstrations in support of the government. But the article fails to mention that the Nicaraguan government ended such public demonstrations on March 14, and it does not mention Honduras and its alternative of using the pandemic to instill fear and tighten control over an already insecure population. The general sense of these criticisms is to condemn Nicaragua for its sometimes questionable practices while ignoring the far more repressive tactics of the Honduran government and, more important the very different levels of infection in the two countries. The criticism is of the means, but it ignores  the results, and so it fails to ask the useful questions.

Some of the coverage of the pandemic does not mention Nicaragua, but rather praises and rewards Honduras. Former U.S. Ambassador to Honduras James Nealon advocates more aid to the Honduran government at this time of crisis, despite the fact that Honduras has no functioning transparency laws, the government has been under international scrutiny for rampant corruption, and human rights and popular organizations express concern that aid intended to fight COVID 19 will line the pockets of corrupt officials or, worse, find its way into the coffers of the Honduran police and military that enforce the repressive policies of the government. The ambassador also argues that more such aid would stem what he thinks will be a new influx of immigrants out of Honduras heading to the U.S. He claims that sending more money to the Honduran government will curb emigration from the country—an assertion contradicted by the history of the past decade during which rising aid to Honduran governments has been accompanied by more, not less, emigration from that country. He calls such aid a “defense” of the United States. Presumably, the U.S. needs to be defended from invading hordes from the south. Such fear mongering has the appearance of another form of disaster opportunism, using COVID 19 to promote failed and harmful U.S. foreign aid and immigration policies.

Is There a Learning Moment Here?

These most recent differences in policy between Honduras and Nicaragua are really a continuation of policy differences going back several decades. In Honduras, the results have produced a situation in which many live a highly insecure and precarious existence where fear, anxiety, and stress are daily results of the high levels of violence, poverty, corruption, political repression, the breakdown of public institutions, and an ethic that emphasizes that individuals are on their own and cannot expect support from their government unless, maybe, they pledge allegiance to the ruling party.  That has made people more vulnerable, and their vulnerability is exacerbated by the daily stress of life in such a context. The current pandemic policies in Honduras have increased the physical and emotional vulnerability of people, leaving them perhaps, more exposed to the pandemic. One can easily detect this anxiety, even desperation, in the food riots and expressions of deep concern from popular organizations and rural communities. In Nicaragua, the policy seems to provide some balance between defense against contagion and the necessities of daily existence in the particular social and cultural context of Nicaraguan life. Public institutions function, and measures to curb the spread of COVID19 seem to be a balance between restricting and enabling.

In the United States, President Trump has been rightly criticized for making light of the COVID19 pandemic, and is held responsible for the soaring number of cases and deaths from the virus. Stricter measures, including social distancing, cancellation of public meetings, closure of businesses, and widespread testing should all have been enforced or at least encouraged by the federal government. In the U.S., this makes sense. But there are also stark statistics emerging that show rates of infection among African-American and Hispanic communities in the U.S. several times higher than among white communities, and concerns about the poorest and most marginalized populations that do not have the resources to stay home, social distance, stay nourished, work online. In the middle of this pandemic, the situation of the most marginalized people in the United States appears not so different from that of the majority of Hondurans and Nicaraguans and the other “marginal” peoples of the world.

Honduras, the United States, and Nicaragua seem to present different ways of dealing with these marginalized people. Nicaragua is tailoring its response to them, perhaps too much so, perhaps not. The U.S. is ignoring them. Honduras is persecuting them. The mainline media seem insensitive to cultural differences and marginalized people, and the media often fail to take account of inequalities. So far, the Nicaraguan strategy of emphasis on education and prevention and an open society with monitored borders seems to be working better than the iron hand strategy of the Honduran government. This does not mean that the United States or any other country should, or could, copy it. But the world should not praise Honduras and condemn Nicaragua for their very different responses, while ignoring the results in the numbers so far.

Some relevant and pressing questions are: Can we learn to avoid using the pandemic for political opportunism in the style of Honduras, while taking into account and being sensitive to the special needs and inequalities that exist among our own populations, in the style of Nicaragua? There are deeper potentially embarrassing questions about the expensive U.S. health care system and its structural inadequacies to support all the country’s people, including poor and marginalized people and frontline medical professionals and staff,  in this time of crisis. What can we learn about effective best practices? And can we keep ideology from obscuring practicality?

James Phillips, Ph.D. is a cultural anthropologist who has studied Honduras and Nicaragua for the past 35 years. He is the author of many articles and, Honduras in Dangerous Times: Resistance and Resilience (Lexington Books, 2015, pb. 2017).      

 
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James Phillips, Ph.d., is a cultural anthropologist at Southern Oregon University. His book, Honduras in Dangerous Times: Resistance and Resiliencewas published by Lexington Books in 2015.