‘There is no sea, only fish’: Effects of United States policy on the health of the displaced in El Salvador

Abstract

The poor health status of El Salvador's displaced is a direct result of government policy which defines civilians as legitimate military targets. The effects of this ‘strategic hamlet’ policy on health is vividly seen in five areas of concern: war related trauma, infectious diseases, malnutrition and insufficient health services due to the repression of health providers and lack of resources. This report documents the major causes of mortality and morbidity among the 500, 000 displaced in El Salvador and discusses the efforts of government and private organizations to meet their health needs. Health services for the displaced are primarily provided by private voluntary organizations which base their work on active neutrality. However, neutrality has become almost as dangerous as active opposition. The active repression of health workers by government security forces has exacerbated the already severe shortage of health care services for the displaced.