Medicine for Democracy

an interview with Benito Vivar

DR. BENITO VIVAR, 47, graduated from medical school in his native El Salvador in the early 1970s. A decade later, he left a lucrative private practice to take organizing responsibilities for clinics and field hospitals to serve the popular and revolutionary movements in El Salvador’s civil war.

Because medical facilities and health care workers are special targets of the Salvadoran government and military, maintahiing these facilities in the areas controlled by the Farabundo Marti National Liberation Front (FMLN) and in “zones of dispute” is higbly difficult and dangerous, as well as expensive, work.

Speaking to a meeting in Detroit, Dr. Vivar explained that supplies must be purchased outside the country and transported to where they are needed. In conditions of military repression, the facilities must also be mobile.

Dr. Vivar was speaking as part of a tour to build North American awareness of and support for the Bravo Fund, a project to provide humanitarian medical aid for the revolutionary forces and for wounded combatants of the FMLN. He spoke in Detroit in place of Pedro Ortiz, an FMLN soldier who lost a leg in combat, whose via application to visit the United States for medical treatment has been bureaucratically stalled by the U.S. State Department.

The Bravo Fund is named in honor of Dr. Alejandra Bravo, a Mexican physician who, with her assistants at a field hospital treating FMLN soldiers, was captured, raped and murdered after for-hire by the Salvadoran armed forces last year.

Against the Current editor David Finkel interviewed Dr. Vivar during his Detroit visit. Dr. Vivar’s answers were translated by Beth Perry of the national office of the Committee in Solidarity with the People of El Salvador (CISPES).

ATC I’d like to ask you first, in view of the enormous changes in world politics, Eastern Europe and East-West relations in the past you, even the put six months: How have these profound changes affected, whether positively or negatively, conditions for struggle in Central America and especially in El Salvador?

Benito Vivar: I think this probably changes perceptions throughout the world, not only in Central America and particularly El Salvador but also here in the United States.

In El Salvador, it reinforces what began to be thought–what the FMLN actually thought—-ten years ago. El Salvador is part of the western hemispherc Its culture, trade and so on evolve in that context To think there would be a direct relation with the East didn’t make sense, and was even dangerous.

The reason we thought this was somewhat dangerous was the possibility of dogma being established or mechanical models applied. And this reasoning, throughout the world as well as specifically in El Salvador, has proven correct: that each country has the right to make its own changes as it sees fit.

This doesn’t eliminate the need to take all the experiences gained from everywhere. But it means that it’s absolutely impossible to fathom copying models based on other conditions.

From the beginning, the FMLN has proposed friendly relations with every country in the world, including, perhaps even with more emphasis, the United States—-simply because the United Stases and El Salvador are in the same continent and the U.S. is so advanced.

The relationship between the United States and Latin America is one of mutual dependence: not only in the economic sphere is this strong, but also politically, culturally and in general, although the political relationship has been the most conflicted. So I can sum up by saying that the position we had and the revolutionary road we have chosen was correct, for the Salvadoran people to make their own changes.

ATC: In a recent interview with the Guardian (U.S.), a Nicaraguan Sandinista cornmandante, Victor Tirado, has stated that “the cycle of anti-imperialist revolutions is over.” Undoubtedly the term “anti-imperialist revolution” can have various meanings, but would you comment on this statement from a Salvadoran perspective?

B.V.: I think that to speak of anti-imperialist struggle in this period is a little bit delicate. I don’t want to contradict the companero, but I will use my own country as an example.

As long as there is injustice, inequality and misery in El Salvador, and the threat of U.S. intervention in my country, there will be a struggle against imperialism. So I consider that as long as such a situation exists in any country, brought on by the United States or any other imperial country, there is anti-imperialist struggle, because people will not accept the idea that this is the time to die of hunger.

I think that given the situation of the killing by the contras, the economic problems in Nicaragua, the coming to power of UNO (the right-wing coalition in Nicaragua—ed.) and its overcoming of the Nicaraguan society with the support of the U.S. government, with all due respect to the companero it is difficult for me to believe that the Nicaraguan people don’t believe they are still fighting against imperialism.

ATC: Can you describe the public health situation in El Salvador, and how it has been affected by the ten years of war?

B.V.: It’s important to begin by saying that the public health services in El Salvador have always been poor. During the war they have become even worse, for two reasons.

First, the government and the army of El Salvador began to prevent medical personnel and supplies from entering areas controlled by the FMLN. In addition, until right now they still try to prevent entry of medicines into the zones of dispute. Further, they are militarily persecuting any hospitals of the FMLN with the objective of destroying them.

The second basic reason is that the equipment in the civilian hospitals has been taken away for use in military hospitals and clinics.

When we speak of areas under FMLN control or in dispute, it’s about three-quarters of the country, including parts of the capital San Salvador. So people have trouble getting medical attention, because there aren’t medical clinics or there aren’t supplies.

Since I haven’t talked yet about private practice, let me mention something that is quite monstrous. That’s the increased costs—-about 600 percent increases—-purchased in the pharmacies. So there are some medicines that people just can’t buy. Some doctor friends have said they will have to close their offices; people can’t buy what they prescribe.

I don’t know exactly, but think there might not be too much difference between prices here in North America and there. If a medicine costs $10 and I make $2000 a month, I can buy it but if I make $2,000 a month, I can buy it; but if I make only $200 a month that medicine is impossible for me to buy. And the minimum wage in El Salvador is much less than $200 a month.

ATC: What is the leading cause of death among children in El Salvador?

B.V.: About 75 percent of children die between ages 1-5. The first reason is malnutrition. This isn’t something that people want to say. Sure, a child who is malnourished and has a cold will die of bronchitis or pneumonia. If they get measles they will also die.

In terms of statistics, they say the most frequent causes of death are diarrhea and then pulmonary diseases. But these are only results of the most obvious and fundamental reason, and that is malnutrition. Everyone knows that without enough protein you will not live.

Milk, which has always been expensive, has increased 100 percent in price since Cristiani (the president and head of right-wing ARENA party—ed.) has been in office. The price of beans, the basic national food, has risen 70 percent Unless the people change the system so that it’s democratic with freedom and justice, they will continue to die of hunger.

ATC: How do you assess the present prospects for the dialogue between the government and the FMLN?

B.V.: I will say, because it’s really true, that the possibilities of negotiation now are better than ever. That’s because the Salvadoran people have achieved the most significant victory of the entire war-—to force the Salvadoran army and government to talk to the FMLN.

This really was the result of the November, 1989 offensive. This offensive was launched, even though it was a very painful decision, because there was no option left. And the offensive also resulted in the U.S. Congress questioning whether to continue aid to the Cristiani government and the military.

So I see definite possibilities for the negotiations; but it’s dependent on the political, military and diplomatic power of the FMLN. In other words: to have the negotiations be a success, the FMLN must increase its power on these levels.

While the U.S. government and the Salvadoran government will continue to say that the FMLN doesn’t really want to negotiate, the issue is: why does the United States continue to arm the Salvadoran government? If the military and the government are asking the FMLN to disarm then they should be prepared to do the same thing.

It’s a childish proposal with myopic vision to ask the FMLN to unilaterally disarm, goodwill gestures are done on both sides or it doesn’t work.

What I personally think right now is that the Salvadoran government and the army are trying to figure away out of the negotiations. Why do I say this? On May 16, the day the negotiations began in Venezuela, the army began an offensive throughout the entire country against all the positions of the FMLN. This operation cost the army about 300 casualties, but also showed that there isn’t the political will to negotiate.

They thought they would catch the FMLN off guard and destroy them, then go to the table and say, you must accept our position or we will wipe you out. Now I would imagine that the FMLN went to the negotiating table very well prepared and said look, you just lost 300 soldiers, why don’t you sit down and negotiate seriously?

Another example was fifteen days ago (late in May—ed.), the army carried out an operation against the repopulated areas in the southern and western zones—-against civilians, unarmed. This is another indication that they don’t want to negotiate. I would imagine that the U.S. government is telling the Salvadoran military and the government to hold on, well get through the criticisms of the bombings and the murders of the Jesuits, then you can go back to what you were doing.

This masked intervention is cruel. It condemns tens of thousands of Salvadorans. And the other aspect of what’s going to make the negotiations a success is an end to all aid to the Salvadoran government. Because I want to reinforce this point: $4.5 billion (in U.S. aid—ed.) over the past ten years for a tiny underdeveloped country is hard to imagine.

That money wasn’t used for investment, to make businesses or anything like that, but for bombs to destroy houses, to buy people to carry out assassinations. We could never pay it back.

Even more significant, we have lost almost 100,000 people killed. We have lost from the workforce not only the dead and wounded, but a million people who have had to leave, and many who cannot contribute to the economy. So it’s fundamental and strategic to end all aid to the Salvadoran government and army.

ATC: In this context, what is your perception of the recent maneuvers in Congress regarding aid to El Salvador?

B.V.: A farce. It’s difficult to understand: in the morning they say they will cut aid to El Salvador, in the afternoon they don’t. (This refers to a measure cutting aid by 50 percent that passed the House in May, but was subsequently killed when the overall bill it amended was defeated—leaving an earlier aid appropriation intact—ed.)

Imagine this is due to pressure from the Administration. I suppose there are diverse opinions within Congress, that some of them question the aid—but Congress is also very vulnerable topressure from the executive branch, at least with regard to aid to El Salvador. I don’t want toy this for sure, because it’s not my expertise, but I do know one thing; that the Administration wants to continue the same policy even though Congress has noted very serious human rights violations and acts of corruption.

Here’s a little example: the assassination of the six Jesuits and two women. If the U.S. really wanted to prosecute the killers, they would certainly be in prison—if not shot—by now. Here in the United States lives the assassin of Archbishop Romero. First they were going to extradite him, now he’s free.

Right now, working in the office of the military high command in El Salvador, are those who killed the Jesuits. Everyone knows who they are, including President Bush—-perhaps he knows even more than others! Yet he continues to want to send aid to El Salvador…. What’s his motivation?

I believe it’s probably because key people in the Administration haven’t been able to change their old ways of thinking. It seems it was easier to change the dogmatists of Eastern Europe than the so-called “democrats” of the United States. They still believe that any kind of revolutionary process or FMLN victory would endanger U.S. national security.

The United States thinks we are going to lose. They don’t realize that even within the context of capitalism, they would win more if they got rid of their old ways.

I don’t see how we could be a threat to the security of the United States, when we haven’t developed the means to feed our people. (But) what would it mean if El Salvador, a very small, poor and underdeveloped country, confronts the U.S. and wins? What would happen with Brazil, Argentina, Peru and the rest of Latin America? I won’t dwell on this; but let the Bush administration think about the situation.

To contribute to meeting the medical needs of the freedom struggle in El Salvador, make your check payable to The Bravo Fund and send it to: US.-El Salvador Institute for Democratic Development, P.O. Box 460586, San Francisco CA 94146.

November-December 1990, ATC 29