In the latest chapter of this fight, the legislative assembly, under pressure from six days of marches and roadblocks by workers, peasants, and youth across the country, ratified a decree November 14 barring moves to privatize the public health system and suspending all existing contracts for the "purchase" of health services as of the end of the year.

In the course of the two-month battle, tens of thousands of doctors and health-care workers, along with other trade unionists, students, peasants, and members of social organizations have participated in numerous protest actions, including three major demonstrations in San Salvador, the capital. The protests began after STISSS, the union that organizes the health-care workers of the Salvadoran Institute of Social Security, went on strike September 18.

The walkout was in response to the firing of 10 union members for actions they allegedly took part in during a one-day strike on September 5 to protest privatization moves already under way. The union of doctors at the institute, SIMETRISSS, joined the strike on September 27. Since then, medical personnel have progressively shut down 10 of the largest hospitals of the institution’s network across the country.

"The time has come for the people to regain their sovereignty and dictate policy to a government that favors the interests of big business in this country," stated Guillermo Mata, president of the Salvadoran Medical Association. "The people of this country can no longer allow themselves to be trampled on."

The strike received widespread support from trade unions, transport workers, shopkeepers, municipal workers, peasant groups, and organizations such as the Citizen’s Alliance Against the Privatization of Public Services, a coalition of some 50 organizations. Employees at private clinics across the country held a one-day general strike October 25 to protest the privatization plans.

Explaining the widespread support for the fight against privatization of health care, Margarita Posada, a leader of the Citizen’s Alliance, commented, "This is a people who have awoken as a result of all the privatization processes that have already occurred, which have been based on false promises that have only led to higher costs and the elimination of services. That is why we dread a privatized health-care system."  
 
Increased resistance of working people
The fight against privatization of health care is part of the increasing resistance of working people against the policies of the right-wing ARENA government. The government of El Salvador, a Central American country of 6.4 million people, has pegged its national currency to the U.S. dollar, and has introduced a 13 percent tax on staple foods and medicines. Previous governments have sold off the banks, telecommunications, and electricity, resulting in the layoff of thousands of public employees, price increases for essential services, and the weakening of the unions.

Workers are facing increasingly harsh economic conditions as a result of the worldwide capitalist crisis. The official poverty rate has increased from 45 percent of households in 1999 to 51 percent in 2001, and real wages lost 30 percent of their value compared to 1988.

The official unemployment figure is 7 percent, and underemployment is 32 percent. By the end of 2001, the total domestic and foreign debt amounted to $4.6 billion, or 32.6 percent of the Gross Domestic Product.

In response to the mounting nationwide protests, President Francisco Flores on October 31 backed off from his threat to veto the anti-privatization bill. He also declared that he would withdraw his "Democratization of Preventive Health Care" proposal--a voucher plan that would pave the way for privatizing health-care services.

The day before Flores’s announcement, workers at the public hospital system began a solidarity strike. The three-day action was the third in a series of progressively longer work stoppages. That same day, the main roads in the country were successfully blocked by protesters for almost three hours.

The ISSS unions joined with other working people in marches and protests throughout the country, some of which were held in front of hospitals supporting the strike. Doctors and workers at the 10 largest hospitals in the public health system began a solidarity strike November 5, while pledging to attend to emergency cases.  
Doctors continue fight
President Flores finally agreed to meet with representatives of the Salvadoran Medical Association, SIMETRISSS, and the public health-care system. After three days of negotiations, Flores, in a last-ditch effort to salvage the health-care privatization scheme, sent an amended bill back to the legislative assembly November 8 to allow public institutions the "freedom to purchase" medical services from private business. In response, the doctors, with wide support from unions and other working people, vowed to continue the fight.

The ratification of the decree outlawing the privatization of health care is being celebrated by strikers and their supporters. In the midst of cheers and applause, Ricardo Monge, secretary general of STISSS, stated, "Through struggle, the Salvadoran people have stopped the privatization of health care." He and other strike leaders have said that the ISSS strike will continue until the decree is signed into law and published in the official register, all the fired workers are reinstated, the doctors and workers that supported the strike receive back pay, and the government guarantees no reprisals against the striking workers.  
 
Electrical workers strike
In a related development, the Union of Workers of the Electrical Sector (STSEL) at the Hydroelectric Executive Commission of the Lempa River (CEL) went on strike on November 11. The strikers demand the reinstatement of 29 trade unionists, including their general secretary, fired without explanation in October 2001, and an end to all such illegal firings and other union-busting activities.

Some 230 workers in the maintenance section nationwide went on strike in support of the CEL employees and fired workers whose 23-day hunger strike to press their demands had been ignored by government officials. Leaders of the strike have declared that it will progressively be extended to other power plants if the government does not respond to their demands.  
 
 
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