On Sunday 16th of April, the north western coast of Ecuador was struck by an earthquake measuring 7.8 on the Richter scale. While, the 16million or so people of this South American country are no strangers to earthquakes, this was one of the biggest to have hit the country in recent times. The quake, which according to the UN is “the region´s worst disaster since 2010”, referring to the 2010 Haiti earthquake, affected almost 720,000 people, leaving almost 660 dead and another 4, 600 injured. Over twenty two thousand people are living in temporary shelters. In addition, there was tremendous damage to property and infrastructure. An estimated 3 billion USD will be required to rebuild; reconstruction, according to Ecuador´s President Rafael Correa, could take several years.
Progressive, long-term investments in the health sector, including increasing the health budget and strengthening the health system, over the last decade by the current government, allowed swift response in the face of a major natural disaster. The representative for Ecuador of the Pan American and World Health Organization (PAHO-WHO), Gina Tambini, recognized the immediate mobilization of professional teams to evaluate the availability of infrastructure and medical care to the affected population. The resident coordinator of the United Nations system in Ecuador, Diego Zorrilla praised the government for its quick and effective response.
And yet, the opinion of the people, towards their government might defer. Political ambivalence brought on by an economic crisis, low credibility of the government at multiple levels, have led to decreasing popularity of President Correa and an uncertainty about the future in the face of an economic crisis. Ecuador, the smallest member of the Organization of the Petroleum Exporting Countries has had a tough year. Oil prices – the most important revenue – steadily declined. Production costs of a barrel of oil are around 39 USD, yet the country gets only 30USD, affecting the overall budget. Correa’s government has been criticized for its economic policy, which resulted in “unsustainability of the public spending pace”, and for new tax regulations; the government has announced austerity measures for 2016 to face the crisis. “It is the worst moment to face such a catastrophe,” said Maggie Barreiro, an economist at San Francisco University in Quito. “The fiscal accounts are empty, and we are having huge problems of liquidity.” Against this economic backdrop the popularity of Rafael Correa is the lowest ever, and elections are just around the corner (February 2017). According to an opinion poll conducted on January 2016, Correa had a 34% of vote intention, down from 47% in October 2015. An error of judgement or not, a video of Correa during his visit to the disaster zone, in which he was quoted saying, “No one loses calm, no one shouts or I will put them in jail, whether old, young, male or female. Nobody mourns or complaints, unless for loved ones who have been lost…” went viral. And so, despite an effort to personally coordinate disaster relief efforts by his cabinet, including a visit to the affected areas – all alongside another important visit to the Vatican – the above quote which was captured on video affected his public image.
Disasters test a nation’s response systems (health, risk management, social protection, public safety, etc.) Some experts from the Red Cross and other humanitarian (UN + international NGOs) emphasize a good national response system risk management has a combination of existing health system capacity and decentralized administrative rationality.
In Ecuador, disaster response is coordinated by the National Secretary for Risk Management (created in 2008), with a decentralized model through the structures of the Emergency Operations Committees (COE) at the national, provincial and county levels. Within 10 thematic tables (these are like working groups) there are actors from various sectors (including private sector, civil society and NGO´s) for the issues mentioned above. In the wake of the earthquake, a state of emergency was declared in the country. Investments in health over the past decade paid off in the system’s ability to respond better to an emergency. The director of the Pan American Health Organization (PAHO), Carissa Etienne, acknowledged this as “impressive” progress in a short time by Ecuador. During her visit, coincidentally one week before the earthquake, she was quoted as saying, “I want to emphasize the increase in the health budget, in these nine years the state public health investment has reached record levels according to the constitutional mandate.” She highlighted how between 2007 and 2014 the budget has quadrupled (2,5 billion USD ,)together with the commitment of the authorities of the Ministry of Public Health in the management and efficient use of those resources, and highlighted the construction between 2011 and 2014 in 10 hospitals, 51 first line health centers, the renovation of eight other hospitals and the addition of nearly 300 ambulances nationwide.
At present, in terms of financing the relief efforts, the national government through the National Assembly, will present new fiscal and tax regulation in order to collect and pool a solidarity fund to face the disaster: 1. An increase of two percentage points in the VAT (from 12% to 14%), for a year; 2. A one-time contribution of an additional 3% on profits; 3. A contribution of 0.9% of individuals with an inheritance greater than one million US dollars; 4. Contribution of a day’s wages by those with a monthly income of greater than 1,000USD, two for those with an income of more than 2,000USD. Those with an income of more than 5000 USD will have to contribute five days of salary, (one day’s wages over five months). This will not apply on the disaster zones, subsidies and taxes exemption will be planned for this region.
Recently, on Saturday the 23rd, President Correa, explained the proposal during his weekly report to the nation, stating that even as donations were important, “cans of tuna not will rebuild the roads”. This led to a national debate on the redistribution of wealth, (initially ignited on 2015, due inheritance tax bill), charity and solidarity.
The earthquake spun the country on its axis. It has weakened the legitimacy of the Government and appears to have driven society in the opposite direction, leading to a fresh dilemma against the backdrop of the crisis – government vs. society. The ongoing debate reflects the current political situation in Latin America. After two decades of progressive trend projects, called “Socialism of the 21st Century” (Heinz Dietrich, 1996), government and society present divergent points. Polarization is not free of political interests. It is not the dialectic rationality among elements of the State; it is a debate of actors in view of the forthcoming elections. One would imagine disaster response bringing people together towards a collective goal; it has, on the contrary, brought the risk of deinstitutionalization. The debate on the size of the State, the utility and the limits of social investment may be necessary, but it is also a reflection of the ethical crisis faced by political actors in Ecuador. The modernization of the State has not gone hand in hand with the shifts in society, and politics of amidst tragedy remains a shameful practice which unfortunately tends to be effective.
At present, the focus is on saving lives. And it has opened the new stage in providing social protection to victims of a disaster, which requires going through a planned system of shelters, as well as the activation of several aspects of a health system’s response: health surveillance, vector control, containment, risk reduction in shelters, etc. Reconstruction is a process that requires planning and requires a comprehensive and public health approach. Even if it is in the middle of a potential, future political crisis.