Human rights complaints mount against Bukele’s state of exception in El Salvador

Andrea Lobo

Last week, human rights organizations in El Salvador issued a joint report that includes over 4,500 human rights complaints against the security forces during the ongoing “state of exception” launched 10 months ago by the government of President Nayib Bukele, ostensibly in a “war against gangs.”

The complaints are mostly of arbitrary detentions, as Bukele openly boasts of having detained almost 63,000 “terrorists,” or 1 percent of the population, without a fair trial. The report also cites “harassment, threats and battery.” One of the organizations, Cristosal, has recorded at least 102 deaths of inmates during the regime of exception.

The Salvadoran ombudsman, moreover, has gathered evidence of hundreds of cases of torture, while Human Rights Watch accessed an official database of 1,082 children detained, as of August 2022.

Military police patrol the Tutunichapa market in San Salvador, February 12 [Photo: @FUERZARMADASV]

The state of exception authorizes troops and police to make warrantless searches and arrests, including of minors as young as 12. It also allows mass trials and trials in absentia, includes 45-year prison sentences for suspected gang members and suspends democratic freedoms, including freedom of speech and the press. As the country approaches a total of 100,000 inmates, Bukele inaugurated this month the largest prison in the world with a capacity of 40,000.

In a country smaller in size than the US state of New Jersey, the massive scale of the roundups is comparable to those carried out by the military dictatorships in Central and South America during the 1970s and 1980s.

Moreover, these policies have been accompanied by an avalanche of fascistic propaganda by officials and most of the media glorifying the security forces and portraying impoverished youth as “rats” and “terrorists.”

In this context, polls show that the state of exception is supported by almost eight in every 10 Salvadorans, with similar numbers feeling “safer,” and the measures have reportedly reduced the number of homicides and other crimes. Recent investigative reports have found that the largest gangs, Barrio 18 and MS13, have been “dismantled” as functioning organizations in the communities surveyed.

The popular support for these policies is partly explained by the fact that workers and small shop owners in El Salvador have faced decades of daily terror and killings by gangs, which have connived with state authorities to profit from “taxes,” drug trafficking, and robberies.

At the same time, only one or two generations ago, a series of brutal military dictatorships backed, armed and trained by the United States, and a subsequent “civilian-led” regime plagued by death squads, massacred tens of thousands of left-wing youth, workers and peasants. The lack of mass opposition from below against what is clearly the establishment of another dictatorship can only be explained by the political bankruptcy of the organizations that claim to be “left.”

When elected to power, the official “left” composed of the Farabundo Marti National Liberation Front (FMLN) quickly abandoned its reform promises to oversee IMF austerity measures, while maintaining El Salvador as a cheap labor platform for transnational corporations. Ultimately, the ex-guerrilla FMLN dropped any opposition to US imperialism, whose brutal domination over the course of a century engendered the economic conditions that have proven to be so fertile for gangs and criminal activity.

While Bukele was expelled from the FMLN, and has since exploited the widespread hatred for all the political forces involved in the civil war (1980-1992), and heading the governments since to refashion himself as an “anti-establishment” figure, he offers no real alternative. This is demonstrated by three facts.

First, his key campaign promise of ending impunity for the crimes committed during the civil war, like the Mozote massacre by the military, has largely been abandoned.

Second, several media reports have found that part of the leadership of the gangs has remained unscathed and moved temporarily to rural areas and neighboring countries. Amid worsening poverty under the boot of a police state, and countless youth unrelated to the gangs now locked away with actual gang members and far from their studies and work, conditions could again be ripe for a violent resurgence of the same gang structures.

Third, and most importantly, as demonstrated by his “let it rip” policies during the ongoing COVID-19 pandemic, Bukele has little concern for the actual safety and lives of the Salvadoran people. The regime of exception responds to the pressing demands by the American ruling elite to establish a “safe corridor” to connect the North American supply chains with the cheap labor and natural resources in Central and the South America.

But this “safety” doesn’t refer to protecting workers and their families, but rather protects the foreign capital investments, factories, products and profits from the workers, even if initially this takes the form of crushing the extortion-seeking gangs.

These corridors are urgently needed by US imperialism as it tries to “near-shore” production and consolidate a North American economic platform to compete against its rivals, including China, Russia and the major European powers.

Any challenge from below that may disrupt these plans will be met by deadly repression. There are indications that the Bukele regime is already using the state of exception to crack down on social opposition. The Development Association of the rural community Santa Marta on Monday denounced the “arbitrary detention” for over a month of five of its leaders under the regime of exception. Those arrested had led protests against mining corporations.

The official poverty rate has jumped to one-third of the population, while 21.4 percent of Salvadorans would like to emigrate, according to a recent IUDOP poll. Such desperate economic conditions will eventually lead to an eruption of the class struggle.

The influential US think-tank Center for Strategic and International Studies (CSIS) published last December a report titled “Advancing U.S. Nearshoring Priorities in Central America with Special Economic Zones.” The report indicates that providing investors “inviting macroeconomic environments” is the first challenge for these nearshoring plans.

“Investors and governments must therefore seek out geographically defined areas, where rule of law, anti-corruption measures, and regulatory stability and predictability characterize the landscape,” the report indicates. Moreover, it proposes a network of US-dominated special economic zones (SEZ) with tax and regulatory incentives where management can rule unimpeded.

The CSIS report focuses in on El Salvador, where Washington has successfully pressured the government to halt plans for a Chinese-dominated special economic zone. The report says this project is troubling because it would mainly benefit China-based investors while “sidelining many U.S. and European companies.”

“With geopolitical considerations front and center, supply chains and the global investment landscape are likely to become less global and more regional,” the report concludes.

While the report describes China as a “nondemocratic competitor,” the corporate incentives and suppression of the class struggle that the CSIS proposes are incompatible with democratic forms of rule. At the same time, this competition will inevitably drag Central America into the maelstrom of a third world war.

Any hypocritical criticism by the Biden administration against Bukele is part of its pressure campaign to pull the country away from China. But even as Bukele attempts to balance ties with US imperialism and China, Washington has become more openly supportive of Bukele’s state of exception.

Human Rights Watch analyst Juan Pappier noted to CNN that, while there was initial criticism of Bukele’s measures by the White House, “more recently we have observed ambiguous positions.” This was confirmed by the response of Biden’s State Department to CNN.

“El Salvador and the United States have a personal interest in making sure these violent criminals remain off the streets,” a spokesperson said, while unconvincingly claiming “grave concerns about human rights violations, arbitrary detentions and deaths.”

Just as in El Salvador, ruling elites across Latin America are prepared to subordinate every social policy to creating “inviting macroeconomic environments” to compete for foreign capital, especially as the crisis of global capitalism worsens.

Governments identified as part of the misnamed “Pink Tide” and openly right-wing regimes alike are emulating Bukele’s repression and implementing their own militarization strategies.

On November 24, only hours after Bukele launched a new phase of his “war,” the supposedly “left” President Xiomara Castro in neighboring Honduras announced an ongoing national state of emergency and military deployment to “suspend constitutional rights where needed.” These are the same security forces that have repeatedly killed protesters and local leaders like Berta Cáceres who opposed the regime installed by the US-backed 2009 coup.

Throughout 2022, the right-wing administration of Guillermo Lasso in Ecuador declared four states of exception in different regions, including one against a national strike in June.

Mexican president Andrés Manuel López Obrador has enshrined into the Constitution the permanent presence of the military on the streets and created a new National Guard that has already been deployed against migrant workers and strikers.

Colombia’s pseudo-left President Gustavo Petro announced last week a US$1.1 billion purchase of military equipment. “Colombia’s forces will be better prepared, more modern, interoperable and adapted to the new realities in the national and regional context,” his defense minister boasted. These are the same security forces that killed thousands of civilians in the 2000s and used live ammunition against mass demonstrations in 2021. In December 2022, Petro renewed troop deployments to Putumayo, where only a few months earlier the military massacred 11 civilians and tried to cover it up by moving the bodies.

Chile’s pseudo-left President Gabriel Boric has kept the military deployed under a state of exception to repress the indigenous population in the south, while Brazil's Workers Party President Lula da Silva has promised massive investments in the military and protected leading military officials who were behind the January 8 fascist coup attempt.

Finally, the US-backed coup regime of Dina Boluarte in Peru has employed a state of emergency, the military and live ammunition to crush mass demonstrations ultimately driven by opposition to the policies subordinated to the mining transnationals and Wall Street.

Opposition mounts in Israel to Netanyahu’s fascistic government

Jean Shaoul

More than 90,000 people rallied outside Israel’s Knesset building in Jerusalem Monday amid a mass strike in opposition to the plans of Prime Minister Benjamin Netanyahu to neuter the judiciary and give his government unchecked powers.

Israelis protest against plans by Prime Minister Benjamin Netanyahu's new government to overhaul the judicial system, in Tel Aviv, Israel, Monday, Feb. 13, 2023. [AP Photo/Oded Balilty]

It follows the sixth mass protest on Saturday evening, when tens of thousands took to the streets in towns and cities across the country, including in the settlement town of Efrat in the Occupied West Bank. Polls show that more than 60 percent of the population want the plans to be either paused or halted altogether.

Last week, around 8,000 army reservists marched 50 kilometres from Latrun to the Supreme Court in Jerusalem under the banner “Brothers in Arms: The March to Save Democracy.”

The protests come just weeks after Netanyahu returned to power with the backing of fascistic, racist and ultra-religious forces committed to an agenda of annexing the West Bank, which Israel has illegally occupied since the 1967 Arab Israeli war. They are determined to reinforce Jewish Supremacy, apartheid rule, and Jewish prayer at the al-Aqsa Mosque; roll back already circumscribed anti-discrimination measures through sweeping changes to Israel’s legal system; and step up police and military repression against the Palestinians, and against workers, Jewish and Palestinian, in Israel itself.

Such a programme entails the gutting of what remains of Israel’s public services and massive transfers to the religious schools and seminaries, under conditions of soaring rents and prices in a country where around 20 percent of its 9.3 million population live in poverty and a handful of families have staggering levels of wealth.

This means eliminating the few restrictions on government power, with a tranche of legislation that had its first reading in parliament Monday. It enables the government to override Supreme Court decisions, while limiting the court’s ability to strike down legislation that infringes on human and civil rights or overturn ministerial appointments, like the reappointment of the thrice-convicted Shas leader Arieh Dery. It also gives the government complete control over judicial appointments.

Further legislation is planned that would abolish the post of attorney general, paving the way to end Netanyahu’s corruption trial and speeding up settlement construction.

Almost the entire legal establishment in Israel have criticised the plans. A layer of secular generals and opposition leaders from Israel’s short-lived and misnamed “government of change” under Naftali Bennett, Yair Lapid and Benny Gantz, many of whom have served under Netanyahu in the past, have come out in ferocious opposition, to the point that media analysts are talking about whether or not a civil war is in the offing.

Netanyahu’s coalition partners have demanded that Lapid and Gantz, along with former generals Moshe Ya’alon and Yair Golan, be “arrested and handcuffed” for the crime of “treason against the homeland” after they called for “widespread civil disobedience” to halt the judicial coup. These right-wing layers, who represent Israel’s high tech employees and the most affluent layers and have few policy differences with Netanyahu, fear that a power grab by a scandal-ridden and indicted prime minister, beholden to fascistic forces, is a danger to the stability of capitalist rule and the Israeli state.

Israel’s allies abroad, including the Biden administration, have voiced “concerns.” Washington fears that its chief attack dog in the region is about to provoke a Palestinian uprising on the West Bank that could spill over into Israel itself and involve neighbouring countries, jeopardising the covert wars against Iran and its allies in the region. This is bound up with their broader plans for war against Russia and China, with which Tehran has drawn closer in recent years.

On Monday, opposition legislators accused the committee chair Simcha Rothman of riding roughshod over Knesset procedure and violating the legislative process, leading to angry denunciations and the forcible ejection of at least 14 opposition legislators from the Knesset chamber. The vote to send the bill for hearing was held despite President Isaac Herzog's call to halt the legislative proceedings.

In the run up to the parliamentary proceedings, the various organisations that have organised the weekly Saturday evening mass rallies issued a call for a general strike on Monday, with opposition leader Lapid appealing to employers to let workers strike to “fight for democracy.”

Arnon Bar-David, chair of the Zionist trade union federation, the Histadrut, wrote to his members to say that he did not intend to join the protests or call for a general strike, declaring absurdly, “Israel is a country of laws and only the head of the Histadrut has the authority to shut down the economy.”

Doctors and health workers, high tech workers, educators, university staff and students were among those joining Monday’s strike and rally, although their trade union leaders also said they did not intend to join the protests, announce a labour dispute or shut down services. This is despite Religious Zionism leader and Finance Minister Bezalel Smotrich promising during the election campaign to ban strikes by workers providing essential services.

The rise of such fascistic, anti-working class forces in a state hailed for supposedly providing a safe and egalitarian haven for Jews who had suffered so terribly at the hands of Hitler’s Nazi regime is part of an international shift among powerful sections of the bourgeoisie. In country after country, right-wing and authoritarian forces are being mobilized to divert and suppress rising social discontent and the alienation of masses of working class people from the traditional parties of the ruling class.

Underlying the breakdown of democratic institutions and norms is the protracted global economic crisis, exacerbated by the pandemic and the disruption to global supply chains that has massively increased social inequality and led to soaring inflation, the extreme growth of militarism and war, and, above all, the intensification of the class struggle.

To the extent that neo-fascistic forces have been able to win broader support, political responsibility rests with the right-wing and anti-working-class character of the nominal “left,” who joined a right-wing “government of change” that continued Netanyahu’s economic policies in the interests of Israel’s oligarchs and upped the oppression of the Palestinians. Last year more Palestinians were killed than at any time since 2005. Some 231 lost their lives to the security forces or far-right settlers, including two with joint US citizenship, Al Jazeera journalist Shireen Abu Akleh and 78-year-old Omar Assad.

These right-wing layers opposed to Netanyahu call for a general alliance of “democratic forces” on a capitalist, pro-austerity basis, seeking little more than a watering down of the government’s plans for the judiciary and Netanyahu’s removal from office. They have no proposals to change a social, economic and political set-up that has enriched the financial aristocracy at the expense of the broad mass of the population, much less any plans to so much as ameliorate the brutal repression of the Palestinians in the occupied territories. There Israeli governments of whatever party coalition operate a de facto military dictatorship, abetted by a corrupt Palestinian bourgeoisie, while Israel’s Palestinian citizens are subject to generalised economic and social discrimination. Indeed, the organizers of the anti-Netanyahu marches have actively discouraged Israeli Palestinians from participating in rallies that are dominated by Israeli flags.

Unprecedented hospital layoffs and closures underway in US health systems

Max Jones

The crisis gripping the health care system in the US is intensifying, with unprecedented numbers of hospital closures on the horizon and new mass layoffs among health care workers. As the world enters the fourth year of the pandemic, and the mass infection policies of the Biden administration and governments around the world continue to ensure the pummeling of health systems, hospitals are also being flooded with children and adults suffering from respiratory illnesses such as respiratory syncytial virus (RSV) and influenza.

In the US alone, by official counts 1.14 million Americans have died from COVID-19, with 20,000 deaths occurring since the start of the new year. A staggering 450 people are dying each day, according to the current seven-day average. Despite President Biden declaring the pandemic over, those infected with the coronavirus are still presenting in hospitals. 

The US health care system is reaching its breaking point, exacerbated by hospital understaffing, particularly among nurses. When one hospital closes, the impact on an entire region is immense. The current rate of hospital closures and layoffs exposes a system organized on the basis of profit, and which lacks any significant planning to provide high quality medical care. 

ProMedica headquarters in Toledo, Ohio [Photo by Ohio Redevelopment Projects / CC BY-SA 4.0]

A recent report in Becker’s Hospital Review noted a vast array of “workforce reduction efforts or job eliminations that were announced within the past three months and/or take effect over the next month,” within health systems. The list includes: 

• Oklahoma University (OU) Health, a teaching hospital in Oklahoma City, which is eliminating “about 100 positions as part of an organizational redesign.”  

• Integris Health, another Oklahoma City-based health system, is “eliminating 200 jobs to curb expenses.”
• ProMedica in Toledo, Ohio, plans to lay off 262 employees, to take effect between March 10 and April 1. 
• On November 11, St. Vincent Charity Medical Center in Cleveland, Ohio, closed its emergency room and inpatient care services, laying off nearly a thousand workers. 
• Memorial Sloan Kettering Cancer Center is laying off 337 employees across 14 sites in New York City, or about 1.8 percent of the cancer center’s 22,500 workforce.
• Pikeville Medical Center in Kentucky laid off 112 employees at the end 2022. 
• Desert Springs Hospital Medical Center in Las Vegas is notifying its workers of upcoming layoffs with its transition to a freestanding emergency department, which will affect 970 employees.
• Kaweah Health in Visalia, California, aims to eliminate 94 positions after lowering its workforce by 106. 

In addition to mass layoffs across the industry, high-level hospital closures are on the horizon with hundreds of jobs at risk. 

A staggering 631 rural hospitals are at risk of closure, with more than 200 hospitals at immediate risk, according to the Center for Healthcare Quality and Payment Reform. Six states are facing the shutdown of at least half of their rural hospitals.

In rural Alabama, 48 percent of hospitals are at risk of closing, with 16 percent in immediate danger. Urban hospitals have been overwhelmed consistently throughout the pandemic due to chronic understaffing. Frank Thomas, CEO at Citizens Baptist Medical Center in Talladega, told the Birmingham Business Journal, “Another problem that has really been difficult through COVID and even as we’re coming out of COVID is the rural hospitals’ ability to transfer patients to a higher level of care in urban markets … When a rural hospital gets a sick patient who maybe needs a higher level of care that the hospital can’t provide, they need to transfer to that higher level of care. And it has just been very difficult for rural hospitals to transfer patients because the urban hospitals are full or either they’re suffering from staffing shortages.”

While rural hospitals are closing at faster rates, urban hospitals are not immune to the closures. Last November, Atlanta Medical Center (AMC), in Atlanta, Georgia, closed, leaving tens of thousands of patients deprived of health care and laying off hundreds of employees. These events, which result in a decline in available health care despite very high demand, illustrate the eroding health care infrastructure in the US.

A registered medical worker dons protective gear before entering a room at a hospital in Royal Oak, Mich. In 2021. [AP Photo/Carlos Osorio]

The impact on surrounding hospitals in Atlanta has been devastating, with the closure of AMC leaving a city with half a million people with access to only one level one trauma center, at Grady Memorial Hospital. Since the closure, there has been a 20 percent increase in trauma patients at Grady, and a 40 percent rise in obstetrics and NICU care, according to Chief Health Policy Officer Ryan Loke. Just three days after the AMC closure, the impact on surrounding hospitals was so immense that the emergency room at Wellstar Atlanta Medical Center was forced to close due to rerouted patients. Severe overcrowding was also reported in the emergency room at Piedmont Atlanta Hospital. 

In Washington D.C. in 2019, one year before the pandemic, the city council voted in favor of plans to close United Medical Center in January 2023. Arnel Jean-Pierre, a nurse who was working at the hospital told the Talk Poverty web site, “The end result is a lot of people are going to suffer.” UMC is the last hospital in nation’s capital not located in the northwest quadrant, the city’s wealthiest section. Jean-Pierre said, “They’re paying taxes just like the folks in Georgetown, [wealthy DC neighborhood]. Why should they have the delay in health care when they face a stroke?” While UMC remains open for the time being, it is unclear when it will shutter its doors. 

Although these trends increased under the pandemic, they are nothing new. According to Fierce Healthcare, the nonprofit Chartis Group, health consultants in Boston, “found that over the past 13 years, 143 facilities have closed and another 453 are vulnerable to shutting their doors.” 

These mass layoffs and closures could not come at a worse time, with potentially deadly long wait times at ERs across North America. Health Services Research journal examined 5 million discharge records from California between October 2015 and the end of 2017 and found a 5.4 percent increase in the chance of death from any cause when a hospital’s emergency room is overcrowded. 

These conditions are connected to the nationwide nursing shortage, with a report from McKinsey & Company last year predicting a shortfall of up to 450,000 registered nurses in the US by 2025.

While health systems in the US and Europe struggle with closures and layoffs, governments are pouring billions of dollars into the NATO proxy war in Ukraine. This past week in the UK, tens of thousands of nurses, EMTs and first responders struck against attacks on the National Health Service (NHS) and for safe staffing.

As death toll in Turkey-Syria earthquake rises, Erdoğan government seeks to cover up responsibility

Ulaş Ateşçi

Yesterday evening, the official death toll from the Kahramanmaraş earthquakes had reached 31,643 in Turkey and 4,614 in Syria. Nine days after the quake, search and rescue operations continue in a small number of places, and it is unknown how many thousands of people are still under the rubble.

International search and rescue teams have warned that the President Recep Tayyip Erdoğan government’s decision to use construction equipment to directly enter the rubble will lead to deaths, not rescues. “We will not be part of this,” a member of the Spanish team told RTVE on his way home.

The bodies of 1,302 Syrian refugees, who died on the Turkish side of the border due to the earthquake, were brought back to Syria, according to Al Jazeera. In Syria, ravaged by NATO’s war for regime change and imperialist sanctions, the risk of outbreaks like cholera is rising. “There was a perfect storm brewing before the earthquake—of increasing food insecurity, collapsing health care systems, the lack of access to safe water and poor sanitation,” Eva Hines, chief of communications for UNICEF in the Syrian capital, Damascus, told Al Jazeera.

In Turkey, Erdoğan’s government has launched investigations into several contractors of buildings that collapsed in the earthquake. A few have been arrested. The scapegoating of a number of contractors is intended to cover up the responsibility of the government, which did almost nothing to prepare for the earthquake before and after, paving the way for massive destruction and loss of life.

The Progressive Lawyers Association (ÇHD) filed a criminal complaint yesterday against those responsible for this cover-up. Its statement declared: “We filed a criminal complaint against ministers, governors and AFAD officials who are responsible for the loss of hundreds of lives due to their negligence and inadequacies in preparation before and response after the earthquake.”

The statement continued: “We have previously filed a criminal complaint against all those responsible for the destruction. [State] Institutions that clearly failed to prepare for the earthquake in terms of search, rescue, debris removal and post-rescue assistance are also responsible for the damage they deepened after the disaster!”

As the Chamber of Architects conducted inspections in the earthquake-hit provinces of Adana, Osmaniye and Hatay, Chamber of Architects Ankara Chair Tezcan Karakuş Candan said, “We observed that the destruction in the affected region was massive. In the provinces where the aftershocks continue, many heavily-and medium-damaged buildings endanger human life. People under serious threat are struggling to survive on the streets under very difficult conditions.”

Candan added, “We are very worried about how those who have not been able to reach out to earthquake victims under the rubble for 6 days will be able to raise these cities to their feet. Especially in Hatay, there is a serious destruction in the new buildings stock.” She added:

From the massive destruction in the new building stock, we have observed that the earthquake regulations issued after the 1999 [Marmara] quake were not implemented, and that no lessons were learned from the earthquakes. In our investigations, we found that our warnings on urbanization and construction in earthquake zones were ignored, and that geological and ground survey studies were incomplete during the preparation of zoning plans.

A Master’s thesis on Antakya, the central district of Hatay, published in 2019, found that “80 percent of the buildings in the urban area consist of risky structures. Although these facts have been put forward in reports, and it is known that this city is in urgent need of transformation, no significant work has been done on this issue to date.”

In his article yesterday, daily Cumhuriyet’s columnist Barış Terkoğlu quoted an earthquake warning letter and a scientific report sent by Hüseyin Alan, Chair of the Chamber of Geological Engineers, to several state institutions, including the Presidency and AFAD, in March 2021. The letter and report were about Maraş, which would be the epicenter of the 2023 earthquake.

“Maraş sits directly on live fault lines or zones. It is necessary to urgently initiate a series of studies to prevent our province of Kahramanmaraş from being affected by earthquake damages,” he wrote in his letter, before adding: “Many settlements in Kahramanmaraş sit on ground units with poor engineering properties.”

According to Terkoğlu, Alan suggested in his letter that “The city should be re-planned according to the map of the live fault lines. Existing buildings must be reviewed and urban transformation work must be carried out. An earthquake plan must be prepared in Maraş.”

The attached scientific report also stated:

Kahramanmaraş is expected to be damaged in an earthquake larger than 6.5-magnitude due to both the severe shaking and the danger of surface faulting. In this case, the wisest approach would be to bring the buildings up to code to withstand earthquake shaking.

But the vital warnings of Alan and many other scientists have gone unheeded. As the World Socialist Web Site explained in yesterday’s Perspective, it was not because the Erdoğan government lacked economic resources or any other material shortcoming. Rather, it was “entirely due to the financial considerations of Turkish and global capitalism, which reject spending on long-term infrastructure, such as ensuring buildings in major fault zones are able to withstand earthquakes, in favor of short-term maximization of profits.”

The fact that disregarding the lives and safety of the people is a ruling class policy can be seen in the latest “construction amnesty” vote in 2018. Eight deputies of the so-called “opposition” Republican People’s Party (CHP) voted “yes” to the regulation brought to parliament by Erdoğan’s Justice and Development Party (AKP) before the June 2018 elections to legalize buildings without the required safety certificates.

Although only five “no” votes came from the Kurdish nationalist People’s Democratic Party (HDP), 43 HDP deputies did not participate in the vote. While no one from the CHP voted “no,” 123 deputies did not participate in the vote. In short, the “opposition” MPs who did not participate in the vote and the bourgeois opposition parties as a whole allowed the law to pass and became accomplices to the government’s crime.

The first words of a survivor in Hatay were a striking example of how the lives and health of people are devalued by the entire political establishment in the service of the capitalist system. According to news reports, Emine Doğu, 51 years old, was rescued from under the rubble at the 138th hour. She told emergency health workers who examined her immediately after the rescue: “I have no money. Please don’t take me to a private hospital.”

Meanwhile, aid volunteer Ali Nusret Berker’s interview with the Independent Türkçe yesterday confirmed claims that tens of thousands of people were abandoned to their fate under the rubble in the quake-affected area, where 13 million people live in Turkey.

Berker said that after the earthquake, he and his friends came to the region on their own and tried to participate in rescue and relief efforts in Hatay’s Samandağ district. The AFAD team they contacted in the district told them, “We scanned all the buildings here. Most of them [under the rubble] are already dead. Don’t go in vain. Better you go back.”

According to the interview, they refused to accept this advice: “Berker and his fellow volunteers claim that at least 350 people were subsequently pulled alive from under the rubble of the buildings.

“If we had been provided with equipment support, maybe half of the people we lost would have come out alive,” he said, adding that there was only a team of 13 people with them in Samandağ, which has a population of 120,000. “We really began to rescue people with our own efforts. But during this time, we started not to hear the voices of the people we heard. We started to lose them. And every government agency we called refused us. We really can’t comprehend what kind of logic there is in leaving people to die.”

Sri Lankan health services “heading for total breakdown”

Saman Gunadasa

Last Thursday, the Sri Lankan Medical Association (SLMA), the peak body for all medical practitioners, held a press conference to warn that the country’s health sector is heading towards as “total breakdown.”

Addressing the media, leading medical experts said that the island confronts a serious emergency with shortages of around 300 essential medicines, including a complete lack of 160 specific items at the medical supplies division, the national distributor of drugs to public hospitals. These medicines include antibiotics, anesthetics and other surgery-related drugs, as well as prenatal, neonatal, pediatric and cancer-treatment medicines.

Doctors and other health workers demonstrating over shortages and higher taxes outside Apecsha cancer hospital, Mharagama, a Colombo suburb [Photo by Health workers]

The Sri Lankan government is implementing the savage budget cuts demanded by the International Monetary Fund (IMF), including slashing funding to the public health service. As part of this year’s budget President Ranil Wickremesinghe, who is also the finance minister, will establish “paying wards” in state hospitals as part of its moves to dismantle what remains of the country’s free health service.

SLMA president Dr Vinya Ariyaratne told the press conference that “the health sector is facing a severe crisis due to the shortage of medicines, surgical equipment and chemicals used in labs.” The costs of these items, he said, “have gone up tremendously,” adversely impacting on the entire health sector.

College of Anesthesiologists and Intensivists president, Dr. Anoma Perera, said the crisis was nationwide, not just affecting rural hospitals, the National Hospital of Sri Lanka or private hospitals. “It impacts you and me, and if we ignore it anymore, there is a looming critical situation,” she said.

“Whether it’s a patient in the Intensive Care Unit, someone who has undergone surgery, an expectant mother who has had a Caesarian section or a victim of an accident, a shortage or lack of medicines impacts on them all,” she continued.

Ongoing shortages and the lack of anesthetics and pain management medicines has limited options for doctors, Perera warned. “In the next few months, the health sector might be compelled to maintain only the most emergency services,” she said.

National Institute of Infectious Diseases consultant Dr. Ananda Wijewickrama pointed out that most hospitals do not even have the facilities to conduct basic blood tests. “Some hospitals can’t even print x-rays. They ask patients to bring a CD so they can burn the images into it,” he said.

The health ministry has responded to this dire situation as a promoter of death, not life. Health Minister Keheliya Rambukwella told the Daily Mirror last weekend, that the ministry has advised hospitals to delay “non-urgent” surgeries and give priority to urgent surgeries.

Health workers across the country—from doctors to junior staff—have been demonstrating outside hospitals for months over shortages of medicinal supplies and demanding improved facilities and working conditions.

Dr. Sanduni Perera protesting high income taxes and lack of medicine outside Apecsha cancer hospital in Mharagama, a Colombo suburb. [Photo by Health workers]

Dr. Sanduni Perera from Apeksha, Sri Lanka’s dedicated cancer hospital, spoke with the media last week during one of these demonstrations. “There is no point patients coming to hospitals if we don’t have facilities to do a surgery and cannot provide them with medicine. We have been demanding the government resolve these issues since last year, but the government has other priorities and the health sector is neglected,” she said.

A Chilaw provincial hospital doctor told the World Socialist Web Site (WSWS): “There are no medicines for patients who come to clinics with diabetes and hypertension. Some of the essential medicines needed for the labor room were obtained through friendly doctors in Australia. We’ve been working with utmost dedication to save the lives of our patients since the height of COVID-19 but there’s a limit to the aid we can obtain from outside.”

A nurse from the same hospital explained that much of the equipment and medicines, including for childbirth, is now being purchased by patients.

The WSWS also spoke to a nurse from the Jaffna Base Hospital. “All hospitals lack medicines, including in the North. We are all facing a dangerous situation,” she said. “We also lack staff, including doctors, nurses, and others, in our hospitals, but the government is not concerned,” she added. She also explained that ambulance services had almost ground to halt in the area because there were no funds to service the vehicles.

A Kandy National Hospital psychiatric ward doctor who spoke with the WSWS said: “We face a dire situation because we do not even have drugs to control the violent and suicidal behavior of aggressive, mentally ill patients.”

A schoolteacher explained that one of her students had been treated at Kandy National Hospital over complications with her kidney transplant. She was treated because she was young, the teacher said, but lots of older patients were still on surgery waiting lists.

Doctors and health workers protest outside Kandy hospital on 20 January 2023. [Photo: WSWS]

The teacher, who is a cancer patient, could not afford to buy the prescribed medicine she needed because it was too expensive. “I had to purchase some cheap alternative,” she said.

The catastrophic situation now facing the health system is a direct result of ongoing and intensifying budget cuts by successive Sri Lankan governments in line with IMF directives.

The run-down state of the health system drastically worsened following the outbreak of the coronavirus pandemic in 2020, which saw hospitals overwhelmed with patients. This catastrophic situation, however, has further deteriorated with cuts to the health budget in response to the country’s debt crisis, inflation and the economic impact of the US-NATO war against Russia in Ukraine.

This year’s allocation for the health sector is just 322 billion rupees ($US880 million) compared to 539 billion rupees for defence and the police. The government’s allocation for health, however, is only on paper. Successive Colombo governments have consistently provided only 1 to 2 percent of the country’s gross domestic product for the health service.

The Wickremesinghe government is currently collecting massively increased funds via its 15 percent value added tax on essentials, including food items, fuel and telecommunications. All monthly wages above 100,000 rupees are now subjected to a 6 to 36 percent pay as you earn tax and imports of all essential items, including medical supplies, have been slashed to minimum.

These increased taxes, however, are not to provide the life and death necessities for the masses but to pay back loans to global creditors organised by successive Colombo governments.

The health sector trade unions continue to make futile appeals to the government to resolve the health disaster while promoting the deadly illusion that the government can be pressured to change course.

The capitalist opposition parties, including the Samagi Jana Balavegaya and Janatha Vimukthi Peramuna, are likewise attempting to exploit rising mass opposition against the government to come to power. Notwithstanding their denunciations of the Wickremesinghe government, these organisations have no fundamental differences with the austerity measures and would impose the same budget cuts if they won office.

Billions of rupees are immediately needed to prevent the collapse of the public health service and to provide free, high-quality health services to the masses. The health service must be urgently provided with the necessary medicines and infrastructure, along with more health workers at all facilities.

Airstrikes on Yemen using UK and US weapons “part of a pattern of violence against civilians”

Jean Shaoul

Britain and the United States provided the Saudi-led coalition with the weapons used in hundreds of attacks on civilians in Yemen between January 2021 and the end of February 2022, according to a recent report by Oxfam.

Martin Butcher, Oxfam’s Policy Advisor on Arms and Conflict, said that the Saudi-led coalition were responsible for at least 87 civilian deaths and 136 injuries, 19 attacks on healthcare facilities and 293 attacks that forced people to flee their homes—39 percent of all attacks causing displacement. “Our analysis shows there is a pattern of violence against civilians, and all sides in this conflict have not done enough to protect civilian life, which they are obligated to do under International Humanitarian Law.”

He added, “The intensity of these attacks would not have been possible without a ready supply of arms. That is why it’s vital the UK government and others must immediately stop the arms sales that are fueling war in Yemen.”

Houthi detention center destroyed by Saudi-led airstrikes that killed at least 60 people in Dhamar province, southwestern Yemen, in September 2019. [AP Photo/Hani Mohammed, File]

The Oxfam report came just days before the Campaign Against Arms Trade (CAAT) launched a lawsuit aimed at ending the British government’s multi-billion pound arms sales, including Typhoon fighter jets, missiles and bombs, as well as ongoing maintenance and support, for use in the Saudi Arabia and United Arab Emirates (UAE)-led war in Yemen.

The UK government’s own rules, adopted in 2014 when it signed the Arms Trade Treaty, prohibit arms sales where there is a “clear risk” that a weapon “might” be used in a serious violation of International Humanitarian Law (IHL). Despite the overwhelming evidence that the coalition has repeatedly breached IHL, the government has continued to promote and protect weapons sales. According to CAAT, the UK has supplied arms worth over £23 billion to Saudi Arabia, when “open licences” are taken into account, several times the official figures provided by the government, since the war in Yemen began in April 2015.

UK special forces are believed to have played a role in the war, while the British military maintains the Saudi warplanes that attack Yemen and provide intelligence support for the coalition.

The British government has persistently rejected calls from the United Nations and other international bodies for a ban on arms sales to Saudi Arabia and the UAE. It boasts of being the second largest exporter of defence items worldwide, after the US, based on the value of orders or contracts signed, with more than half by value going to the Middle East.

The venal Saudi monarchy, which routinely assassinates its opponents, tortures, imprisons and beheads oppositionists and dissidents, and the repressive UAE provide the major props for Britain’s defence industry—one of its few remaining manufacturing sectors. They serve as key custodians of Britain’s geostrategic interests in the energy-rich region and as allies in the Washington-led campaign to isolate Iran and its regional allies in Iraq, Syria, Lebanon and Yemen, as part of broader preparations for war with Russia and China, with which Tehran has forged close relations.

Prime Minister Rishi Sunak’s government is intent on maintaining the barbaric House of Saud’s control over the Arabian Peninsula. It is suppressing any information that Riyadh or its backers are committing war crimes and avoiding accusations that the UK is violating its own rules against supplying arms.

In June 2019, a Court of Appeal ruling, following legal action by CAAT, concluded that the Government’s decision-making process for granting export licences was “irrational” and therefore “unlawful.” It forced the government to stop issuing export licences for weapons that could be used in the war in Yemen pending a review of how these weapons had been used and to ensure that future arms sales complied with the government’s own rules and procedures.

But in July 2020, then Trade Secretary Liz Truss resumed arms sales, claiming any violations of IHL were only “isolated incidents.” Since then, the British government has licensed at least £2.2 billion additional weapons sales to the coalition, while cutting its 2021-22 aid to Yemen by more than half.

CAAT’s latest case in the High Court challenges the government’s claims that there were only a “small number” of IHL violations by coalition forces that did not form part of a “pattern,” citing overwhelming evidence to the contrary. Even if there were only “isolated incidents” of violations, this could still involve a clear risk of further violations.

For the last eight years, Saudi Arabia and the UAE have been waging war in Yemen, the Middle East’s most impoverished nation, condemned as near genocidal by rights’ organisations and charities, against rebels that overthrew the hated Saudi-imposed government. At the end of 2021, the UN estimated that the protracted onslaught had claimed the lives of 377,000 Yemenis, 150,000 as a direct result of the war and the rest through “a lack of food or access to healthcare, as well as by the lack of basic infrastructure to provide these services.”

Some 4.3 million people have been displaced, while horrific social and economic conditions, including a cholera outbreak that has raged since 2016 and the pandemic, have prevented people from returning to their homes. The war has destroyed much of Yemen’s public health system, leaving only 50 percent of health facilities operational, with most of these barely functioning due to damaged infrastructure and lack of healthcare workers. Last year’s heavy seasonal rain, windstorms, landslides, and flooding added to the catastrophic conditions, causing deaths and injuries that affected more than 210,000 people.

More than 21.5 million Yemenis are in need of assistance and 17.3 million are suffering from acute hunger, including over two million children with acute malnutrition.

Despite a six-month-long ceasefire and a significant drop in fatalities, the slaughter has continued, with at least 643 Yemeni civilians killed in 2022, including at least 102 children and 27 women, of over 3,000 casualties recorded, according to data published by the Yemen-based Eye for Humanity Centre for Rights and Development. The destruction of over 14,300 homes, 12 hospitals, 64 schools, and 22 power stations has added to the suffering.

The British government has refused Freedom of Information requests from the website Middle East Eye for the release of documents surrounding its arms sales to Riyadh between October 1 and 15, 2016. A Saudi-led coalition’s air strike on a crowded funeral hall in Sanaa killed more than 140 people and injured over 500 on October 8, 2016, an attack UN monitors found violated international humanitarian law. It rejected the requests after lengthy delays, firstly citing exemptions for policy-making decisions and decisions prejudicial to the UK’s foreign and commercial interests and, when that was shown to be incorrect, then claiming it would be too costly to retrieve the documents.

The government’s refusal to provide the information testifies to the widespread and deep hostility of the British public to the government’s arming of the coalition.

The British government supports some of the most barbaric and repressive regimes on the planet. Its continued supply of arms to the Saudi-led war on Yemen explodes its claims to promote human rights and democracy on the international arena, including the torrent of hypocrisy seeking to justify NATO’s military intervention against Russia in Ukraine.

UK survey shows nurses’ mental health is at its lowest point in the pandemic

Erik Schreiber

In the fourth year of the COVID-19 pandemic, the psychological state of a significant section of the health care workforce is at its lowest point. In a survey conducted by Nursing Times, 40 percent of nurses reported that their mental health is “worse” or “much worse” now than it was in 2020 or 2021. Participants also characterized their colleagues’ morale as “poor” or “very poor.” 

These stark findings reflect the heavy personal toll that the crisis in health care is taking on workers. Nursing Times is published in the United Kingdom, but nurses and other health care workers in every country face the same conditions. Surveys conducted around the world would doubtless yield similar results. 

Illness, burnout and retirements have increased sharply during the pandemic, and all these factors have contributed to understaffing. Unable to cope with increased workloads, higher patient acuity and a lack of workplace support, many nurses are leaving the profession entirely. The problem of understaffing afflicts not only NHS nurses, but health care workers around the world. Nurses and other health care workers in the United States, Turkey, Sri Lanka and other countries have conducted major strikes in recent months.

National Health Service nurses picket line in Bath during the national strike on December 15, 2022 [Photo: WSWS]

One of the almost 1,000 nurses who responded to the survey told Nursing Times that he or she had “never felt so lonely and anxious” as now. “We are all different people from who we were before the pandemic,” said the third-year student nurse. 

A nurse with 26 years’ experience called 2022 the hardest year of his or her career. “Recent years have required sustained high levels of resilience. I cannot sustain that level much longer—it is exhausting.” 

About 61 percent of survey respondents said that their mental health had worsened since the beginning of the pandemic, and 20 percent reported symptoms of post-traumatic stress disorder. One community nurse reported having flashbacks to a previous redeployment to critical care. Another respondent reported frequent work-related nightmares. Anxiety and a tendency to cry if reminded of a painful moment were also mentioned.

Most alarming are nurses’ reports of suicidal thoughts. “I have recently had a period of time off feeling suicidal,” said a hospital nurse. “I believe as a result of PTSD combined with the current staffing pressures, and not being able to do my job to a decent standard because of this.” 

The survey also revealed that most hospitals are doing nothing to alleviate nurses’ mental suffering. While 29 percent of respondents said that workplace mental health support had improved since the pandemic began, almost half (49 percent) said that it had not changed. Moreover, 21 percent said that workplace mental health support had worsened. 

About 79 percent of nurses cited understaffing as the primary factor worsening their mental health. The increased burden that this situation places on the workers who remain is causing anxiety. “I worry about making mistakes or omissions due to the heavy workload,” a National Health Service (NHS) nurse told Nursing Times. “We are unable to care for our patients properly, putting lives at risk,” said another. 

Other factors taking a toll on nurses’ mental health include the increasing cost of living (which was cited by 65 percent of respondents) and insufficient pay (56 percent). “I am not making enough money to meet utility bills once other essentials are covered,” one NHS nurse told Nursing Times. In addition, 45 percent of nurses said that their mental health was affected by their inability to take all their breaks, and 39 percent cited ongoing challenges related to COVID-19. Insufficient supplies of personal protective equipment (PPE) are also a source of stress. 

Respondents pointed to one major change that would vastly improve their psychological state. “If I came in to work on a fully staffed and safe ward, and was able to do my job fully and leave feeling that I had done everything I needed to do for my patients and colleagues, my mental health would not be as bad as it is,” said an NHS nurse. 

Fundamental political and economic processes underlie the health care staffing crisis. In the UK, the NHS has been underfunded deliberately for years by both Labour and Conservative governments and can no longer provide the level of care that patients need. Labour leader Sir Keir Starmer, a declared opponent of strikes, has denounced NHS workers’ pay demands as unrealistic and is committed to an austerity agenda in government.

The pandemic has been used as an excuse to funnel NHS funds to private companies (many of which have ties to members of Parliament) to purchase faulty PPE and other supplies. In addition to enriching well-connected companies, the government aims to privatize the most lucrative sectors of the NHS and reduce the rest to an empty husk. This agenda jeopardizes the very existence of the NHS as a public service. 

In the US and elsewhere, the major hospital corporations have maintained inadequate staffing levels to cut costs and increase their profits. This policy was in place even before the pandemic, which has only exacerbated the problem. Last year, major health systems laid off employees to maintain profits amid rising supply costs. Layoffs have taken place at Ascension St. Vincent Dunn in Indiana, Blessing Health System in Iowa, Shriners Hospital for Children in Florida, Sparrow Health System in Michigan and Trinity Health in Massachusetts and Pennsylvania. 

Health systems are being deprived of staff and resources at a time when public health is facing unprecedented threats. The needs of patients and health care workers are being sacrificed in the interests of the major hospital corporations’ profits. These developments illustrate the fundamental irrationality of for-profit medicine, which is incapable of providing a high standard of care. 

Rather than fighting against austerity on behalf of nurses and their patients, the trade unions are striving to suppress workers’ rebellions and enforce the agendas of governments and hospital management. In the UK, Pat Cullen, general secretary of the Royal College of Nursing, has been limiting NHS workers’ strikes to one or two days instead of waging an indefinite struggle. She also has announced her willingness to accept a contract that includes a raise of 7.5 percent, when inflation is greater than 13 percent. In the US, the New York Nurses Association recently divided striking workers at several hospitals and stampeded them into accepting contracts that neither ensure safe staffing nor provide acceptable wages.