"Colapsado" -- collapsed -- this is the word currently used to describe the state of the public hospital system in El Salvador.   The system is overwhelmed by suspected cases of novel coronavirus.   The cases are labelled as "suspected" because there are not enough tests to use on most people presenting with symptoms of the pandemic disease.   If the virus kills someone before they receive a test, the death will never be logged in the official COVID-19 death count.

Every indicator in the official statistics of the growing impact of the disease has been rising steadily throughout June until the present.  The "curve" is definitely not flat.  Daily new confirmed cases, persons hospitalized, daily deaths, percentage of positive test results have all climbed.  The official death toll as of July 5 is 223 for persons who received a positive COVID-19 test, but the actual total could be multiples higher according to reports from municipal cemeteries where suspected cases are buried under specific protocols.

This week pictures spilled out into social media and the press of  a collapsed system of overflowing public hospitals without sufficient beds and cadavers wrapped in sheets lining a hallway.  Scenes from the Hospital General of the ISSS system in the video contained in this article  from La Prensa Grafica show a facility bursting at the seams.       

The new Hospital El Salvador is beginning to fill with COVID-19 patients transferred from other hospitals, but it still has challenges with adequate staffing and being fully equipped.  The new hospital was nearing its first 100 patients last week.  

Meanwhile, those who work in these hospitals are paying a steep price. Over the weekend, both El Diario de Hoy and La Prensa Grafica dedicated an entire front page to healthcare workers who had died after contracting COVID-19. La Prensa had tallied at least 44 healthcare workers fallen, although there is no official tally.  A gallery of deceased medical professionals is here.


The Bukele government has now declared that phase 2 of the country’s reopening plan will have to be delayed for two weeks because of the continuing increase in COVID-19 cases and deaths. Phase 2, which would include the restart of the public transportation system will now occur on July 21 at the earliest. 

Nayib Bukele and the Legislative Assembly continue to be completely unable to work together. Currently their dispute is focused on whether the government can declare a country-wide strict quarantine, or whether quarantines and sanitary blockades may only be imposed on a local or regional basis. Bukele continues to declare that only a strict, nationwide stay-at-home quarantine which he can enforce with security forces will be sufficient to combat the pandemic. 

As the pandemic grows in the country without any coordinated response, public actors are quick to point the blame at others, claiming such things as: 
  • The population is to blame --- Salvadorans just will not comply with the recommended measures for their own protection.
  • The Legislative Assembly is to blame – it refuses to give Nayib Bukele the tools he needs to fight the virus.
  • Nayib Bukele is to blame – he refuses to accept advice from universities and experts and insists that only he and his small group of advisers know the solution to the current crisis.
  • The prior FMLN and ARENA governments are to blame – they left a public hospital system which has not received adequate investment and modernization for decades.
  • The business community is to blame – they only care about profits and are forcing the reopening of the economy regardless of the impact on the health of the Salvadoran people.

All of the above can claim a share of the truth, but passing blame around does little productive to confront the national emergency.

And despite the blame rhetoric going around from their political leaders, the Salvadoran people continue to respond to the needs of their neighbors with acts of great solidarity.  These gestures take a variety of forms from an individual gift of food in response to a white flag signifying hunger, to youth who tutor elementary school age children missing school for a third month, to an impromptu food drive in a middle class community to help out needy families, to churches which provide food baskets not just to their members but to entire communities, to survivors of COVID-19 who are donating their plasma. and to the hundreds and hundreds of healthcare workers risking their lives caring for the pandemic's victims. 

Their political leaders need the same spirit of solidarity.  


Great post Tim! Hopefully things turn around and the Hospital El Salvador fulfills the hype.