El Salvador Perspectives

The healthcare delivery system in El Salvador has three tiers, depending on how care is paid for.   In the bottom tier is the public hospital system.  This system, administered by the Ministry of Health, provides free or very low cost healthcare to Salvadorans of limited means who do not have employment in the formal economy. The middle tier is the social security hospital system (ISSS), which supports care for persons who work in the formal economy and who pay into the system along with their employers to receive healthcare and pension benefits from the government. The third tier is the private healthcare system. This is healthcare provided by private hospitals or doctors in private clinics whose charges are paid by the wealthy who can afford private health insurance. The country’s national healthcare plan is deemed a national secret and is not available to the public.   So we can only look at where the government is operating openly.  Hospital R...

In his  June 1  speech on inauguration to his unconstitutional second consecutive term in office, Nayib Bukele told the Salvadoran public to expect the need for "bitter medicine" if the country was going to achieve economic growth and prosperity.  It was a speech with a prolonged metaphor about following the advice of the wise doctor (Bukele).  Today, the Salvadoran healthcare system might be one example of the bitter medicine the Bukele regime is prescribing. Ask Salvadorans who rely on the public health system or the social security system, and they will describe problems with long wait times, the unavailability of specialists, and drugs which are never in stock.  These are problems of long standing. At least 150 specialists and sub-specialist physicians in the social security hospital system have quit since the beginning of the year  for reasons of low pay and working conditions.   The result is a shortage of specialists in the social security...

Alejandro Muyshondt Days after publicly denouncing a Nuevas Ideas legislator for corruption, Nayib Bukele's national security advisor, Alejandro Muyshondt, was arrested in August 2023 and accused of being a spy for former president in exile Mauricio Funes. Muyshondt disappeared into the incarceration system of the State of Exception, and six months later he was dead. His case is one that leaves more questions than answers, and the government of Bukele is remaining silent on the matter. Alejandro Muyshondt served as a national security advisor to Bukele starting at the beginning of Bukele's presidency in June 2019. Muyshondt had previously served as an advisor to Bukele from 2017 to 2019 while Bukele was mayor of San Salvador, and they were reportedly childhood friends. According to Muyshondt's  curriculum vitae on the Transparency Portal of the Salvadoran government, he graduated from the University of Angers in France with a degree in criminology in 2003, and in 2008 foun...

Flooding in Olocuilta July 9 El Salvador Perspectives has been on vacation for the past month.  Here is a short summary of some of the major stories during that time. Flooding rains which impacted much of the country continue. Days of flooding rain began in mid-June over El Salvador and other parts of Central America as tropical weather systems impacted the region.  In El Salvador, at least 19 people died in floods, mudslides and other calamities due to the rain between June 14 and 19 with thousands forced to evacuate to government run shelters.  After that first week of flooding in mid-June, the country continued to be buffeted by more storms and rains.  Saturated soils meant that rainfall runoff quickly overran river banks or prompted trees to fall over.   The storms have continued in early July.   As of July 8, there were 8 government run shelters open housing 196 people.  A child drowned in flood waters over the weekend.  Beyond ...

This article was originally published on  Undark  under the title In El Salvador and Beyond, an Unsolved Kidney Disease Mystery . November 16, 2022 by Fletcher Reveley J osé Lopez didn’t want to die, but the alternative — having a scalpel plunged through his abdominal wall to install a soft, silicone dialysis catheter — filled him with terror. For weeks in the fall of 2021, the then-34-year-old agricultural worker from Tierra Blanca, El Salvador, had refused the surgery, holding out instead for a miracle from God. Regional lore held that such acts of grace were possible: There was the man from Las Salinas whose invocations had restored his ailing kidneys; the boy from La Noria who was recovering swiftly after devoting himself to the gospel. Through his mounting illness, Lopez clung to the rumors and prayed for a similar deliverance. But he was running out of time. The fluid buildup in his abdomen had grown so severe he felt like he was choking. He couldn’t stand, eat, or s...