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The Doctor, The Dictator, The Dunce: COVID and the presidents in Guatemala, El Salvador & the US

Frequently, when one Central American leader increases his authoritarian approach, neighboring country leaders feel emboldened to follow. In the past few weeks, El Saldavor’s Nayib Bukele has made international headlines for his harsh restrictions, abrogation of basic human rights and power grab in attempting to combat the coronavirus. But unexpectedly, Guatemala’s new President Alejandro Giammattei has chosen not to play “follow the leader.” To date, he is wearing the hat of a doctor rather than the camouflage cap of a typical Central American military dictator, prioritizing text-book public health practices in a poor country where social distancing is extremely difficult. Most notably, he has not yet compromised human rights nor fomented fear in order to ensure compliance; nor has he used the opportunity to increase his powers beyond what is necessary to combat the virus. In fact, Guatemala has been more successful in “flattening the curve” than anyone would have expected. This is a country where people live close together in poverty. The health care system is very fragile. The government has a long history of corruption, unaccountability and failure to prioritize the needs of the majority of its population, especially the indigenous Maya. Yet today, Guatemala has one of the lowest number of COVID-19 cases and deaths per capita in the world. Half the rates of neighboring El Salvador. And far below its wealthy big brother – the United States.

 I’ve had the unique opportunity to watch this unexpected scenario unfold first hand. I got “stuck” in Guatemala when the government closed the borders in mid-March. Over the last eight weeks, as a member of the Cristosal Board of Directors, I’ve been comparing the governmental and societal responses in three countries -- my home country, the United States, Guatemala, and its neighbor, El Salvador. As I see it, Giammattei has led from the perspective of a doctor. Bukele has viewed the pandemic as an opportunity to increase his personal power. And Trump has employed the lens of partisan politics, with disastrous results.  I offer a few observations and implications for human rights work in the region. Authoritarian governments are excellent at making people comply with public health requirements to contain the coronavirus. But Guatemala’s success stems in part from Giammattei’s choice to wear the cap of a doctor rather than a soldier. This relative success will probably increase his political capital with the public – which was low when he took office in January. But the country is now facing the bigger challenge -- widespread hunger and even starvation due to the economic shutdown. How can human rights supporters and international leaders incentivize Giammattei to build on his successes in pro-democratic ways, rather than regress to the anti-democratic tendencies he was sowing before the coronavirus hit?


LOW-EXPECTATIONS FOR GUATEMALA'S NEW PRESIDENT

In the brief six-weeks of his pre-virus presidency, Giammattei looked like he would follow Bukele’s playbook of vilifying human rights organizations as “enemies of the state.” With the support of the legislative assembly, he was advancing new financial regulations that would defang human rights and other civil society organizations that challenge government corruption, unaccountability and authoritarian tendencies. As a social conservative, he was denouncing the LGBT community at a time when hate crimes were increasing. Although trained as a doctor, he was best known for running Guatemala’s prison system from 2006 to 2008.   Then, on March 16, both Guatemala and El Salvador registered their first cases of COVID-19 among people returning from Europe – and slammed their borders shut. Guatemala immediately began a system of contact tracing and required a 14-day self-quarantine for anyone who came in contact with someone testing positive. In the first month, cases were small enough that government officials were able to regularly visit to check quarantined people for symptoms. Anyone who tested positive was taken to a hospital built JUST for COVID-19 patients, so that they wouldn’t infect family members.   When the first “community case” was detected a week later, traced to the relative of a person who had returned from Spain, the whole country was ordered to “QuedateSuCasa” (“Stay in your house”), with just 48 hours notice. Giammattei knew that the country’s fragile health care system could not handle the surge in hospitalizations seen in Europe and the U.S. So, he acted decisively.   All schools, parks, beaches and non-essential businesses were closed. All forms of public transportation that carried more than 5 people were banned. Travel outside your home region was banned. A 4 PM to 4 AM curfew was imposed – with stiff enforcement fines. Gatherings of more than 5 people were banned – including the colorful weekly Semana Santa parades, which, in Guatemala, was tantamount to cancelling Christmas.   

EXPECTING FEAR AS THE TOOL FOR COMPLIANCE

In the first few days, it looked like both Guatemala and El Salvador would fall back on fear tactics to enforce the mandated public health practices. I saw Guatemaltecos quickly comply because, in countries like El Salvador and Guatemala, no one expects justice to be administered fairly or effectively. This perception is especially true here in the Mayan Highlands, where I am staying and where memories of the government’s 30-year civil war against the indigenous population remain vivid. When my host mother Ana, a widow of 60 who had lived through the civil war, first heard there would be a nationally televised presidential address on Monday March 16, her reaction was: “I wonder if it is another military coup”? The following Saturday night, when we heard tiny loudspeakers from police cars blaring the announcement about the “toque de queda” -- curfew  -- I saw Ana’s body tense up. “Why,” Ana asked,” do they treat every problem, every issue, as a war? They always bring in the soldiers.” The penalties for breaking curfew were stiff – 3 days of jail in Guatemala and a month in El Salvador. And they were highly publicized. In the first few days, newspapers prominently featured photos of people arrested for breaking the curfew and reported the number of arrests (see Table 2).

GIAMMATTEI CHOOSES THE DOCTOR’S CAP

But, in a surprising evolution, Guatemala never adopted either a tone of a war or harsh punishment to enforce public health mandates, approaches that dominated Bukele’s response in El Salvador. Instead, Giammattei has chosen to lead with his “doctor’s” cap, both in addressing the nation and in determining policies. In his first national address on the subject, he sounded more like a kindly neighborhood physician gently explaining why it was important to take your medicine. Since then, he has tried to inspire citizens to comply by calling on them to look out for the greater good.

This tone contrasts with the voice of Bukele, who has positioned himself as “Punisher in Chief” and labeled people breaking curfew as “enemies of the state.” Bukele publicly brags at how many curfew breakers have been arrested and held in containment centers for 30 days. The human rights violations and power grab has appalled leaders around the world. Arrests now surpassing 3,000, have been widely viewed as arbitrary, included a mother who took her 4-year-old to a bathroom across the alley because their house had no bathroom. Detainees in these containment centers, which have become breeding grounds for COVID-19,  are sometimes tested for COVID-19, but not always given their results. Moreover, he has used the emergency as an excuse to vastly expand his powers to issue laws without the check and balance approval of the Legislative Assembly. Even the Salvadoran Supreme Court, often timid, ruled that his suspension of Habeas Corpus rights for arrests for breaking curfew were unconstitutional.   One might have expected Guatemala, with a similar history of repressive responses, to follow suit. Instead, nearly all people arrested for breaking curfew here have been issued a warning and escorted home. The only people jailed are people who have broken curfew multiple times.    Over the last eight weeks, Giammattei has toured the new coronavirus hospitals, not just in the capital city but also in rural areas, which Guatemalan presidents usually don’t visit. In contrast to Trump and Bukele, Giammattei almost always wears a mask during his public appearances and in his weekly televised addresses to the nation (See photo below from a May national speech). So when he implemented a law requiring the wearing of masks two weeks ago, people quickly complied, in part because he had modelled the behavior.  (Of course, the fine of about $920 also helps.) The early and swift response in Guatemala contrasts with the slow and tentative actions in my home state of Washington – viewed in the U.S as a model of scientifically-led response.  Despite having registered the first cases in the country in late February, Governor Jay Inslee approached the shutdown in stages over six weeks. He did not feel he had the public support to issue a Stay At Home order until March 23. As Washington State began to open up this week, the region’s widely respected hero of the coronavirus containment efforts, King County Public Health Director Jeff Duchin felt he could only muster the authority to highly recommend, but not require wearing masks in public.  And he felt the need to add, “It’s not essential that every one of us comply for this to work, so if there are a few who can’t or don’t, this will still be an effective intervention if most of us do.” Among conservatives in the U.S., the “human right” to be defended is the individual freedom to act in one’s own personal interest despite the threat to community health, as exemplified by nation-wide “Open Up Protests.”

PUBLIC HEALTH MEASURES HAMPERED BY EXPORT OF DEPORTEES

Unfortunately, the effectiveness of Giamettei’s early public health containment efforts have been undermined by the United States. Trump has insisted on sending planeloads of deportees, a large portion of whom test positive for coronavirus when they arrive. Giammattei has tried several times to refuse the planeloads, but then relented under pressure.   Giammattei could have made these deportees into villains and “fall-guys” for the spread of the virus, as evidenced by Trump’s continual disparagement of immigrants and refugees. Instead, Giammattei has urged Guatemalans to receive their returning fellow citizen kindly. When a mob of local villagers beat up a returning deportee, despite papers proving that he had passed his 15 day quarantine, Giammattei used his Sunday presidential address to urge compassion. When it was discovered that COVID-19 hospital patients were mistreating deportees housed with them, separate quarters just for deportees were arranged. 


HUNGER ON HORIZON AS THE BIGGER KILLER While Guatemala succeeded in “flattening the curve” of the coronavirus for 8 weeks, by mid May, Cases are now increasing rapidly, due in part to infected deportees from the U.S. So, this week, Giammattei had to move from a strategy of containment to mitigation. More significantly, Guatemala now faces what may prove to be the larger challenge. Eight weeks of an economic shutdown has led to growing hunger and even starvation. Shutting down the economy has taken a huge toll, in a country where more than half the population works in the informal economy and tourism contributes about 8% to the GDP.  Unfortunately, in the economic sphere, Giammattei’s response has been more typical of Central American governments – slow, inefficient distribution of promised relief payments and charges of corruption in implementing programs. Many Maya families in the highlands region are relying on U.S. funded local NGOs rather than their own government for food supplements (see below). While he has so far resisted pressure from powerful business leaders to quickly open the economy, he did veto a bill that would have made it illegal to cut off people’s water and electricity if they couldn’t pay their bills.

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