The fire that engulfed San Borja Hospital, one of the major hospitals in Santiago this past Saturday, bears the hallmarks of decades of underfunding and under-resourcing of the public health system by right-wing and “left” governments alike. Amid an alarming escalation of COVID-19 cases that has national intensive care units at 92 percent occupancy, such avoidable catastrophes can only speed up the collapse of an already debilitated health system.
It is due both to good fortune as well as the decisive action and dedication of health professionals and emergency services that no one was injured. Around 300 firefighters, 40 fire engines and emergency vehicles battled the blaze after the alert was raised at around 7 a.m. In less than two hours, health staff evacuated the majority of patients, some 300 in total, to safe areas of the hospital to determine who could be discharged and to transfer others, including ICU patients, to already stretched health facilities across Santiago.
A San Borjan doctor from the pediatric wing movingly described how he and other health personnel, some of whom were on vacation, quickly responded to the news that their hospital had caught on fire: “I received the news, got dressed and went to the hospital ... the pediatric staff behaved impeccably. There were 19 hospitalized children, all of them were brought down in a calm manner, all of them in order, all of the staff knew what to do, everything as we always learned about transfers. It was a marvel, the commitment of everyone.”
It remains unclear the exact trigger for the fire that started in the boiler room; an investigation is ongoing. The initial report indicated an electrical fault. What is certain is that with years of financial neglect, insufficient maintenance and obsolete equipment, such incidents are bound to happen.
This is the conclusion that millions in the country have drawn. A video has gone viral of an angry San Borja worker confronting the Health Minister Enrique Paris while he was giving a press conference in the vicinity. “You have done nothing! You come for the TV and for the photo op, nothing else,” he said as he was moved along.
Film of four hospitals being inundated with rainwater only 24 hours later also went viral. The worst hit was the El Pino Hospital, located in the San Bernardo district. A hospital communiqué stated that the “facility suffered several incidents in its installations. For the most part, these are minor leaks and filtrations. But around 4:00 p.m. there was a major incident in the Maternal Emergency Service (where) the false ceiling broke due to the accumulated water that exceeded the capacity of the rainwater filtration systems.”
Heavy rains in the Metropolitan Region on Sunday also affected the Buin Hospital, the Padre Hurtado Hospital and the San Borja Hospital.
Iván González Tapia is an architect who was involved in an inquiry into the state of the public system under the military dictatorship that was commissioned by the then incoming civilian government in 1989. The center-left “Concertación” Coalition, which included the Socialist Party and was supported from the sidelines by the Stalinist Communist Party, held consecutive power from 1990 until 2010.
Referring to the tragedy at San Borja, Gonzalez raised in an opinion piece that fires in urban buildings are never the result of unforeseeable natural events:
“The causes that produce them are, always, what we have been permanently claiming for these and other catastrophes: the lack of planning, management and maintenance. This, which should seem obvious, is not attended to in Chile with the dedication and provision of minimum indispensable means to avoid the risks and catastrophes that adequate planning will always be able to anticipate.”
The commission Gonzalez had been involved in 1989 verified that in the 17 years of military rule most of the urban buildings had fallen into utter disrepair.
He wrote: “Among them, the health area stood out for its enormous deficiencies, since out of a minimum budget for their replacement and maintenance, not even half of what was required had been invested. We are not surprised, then, by what happened in San Borja … which today does not even have the necessary means to attend to the patients it receives.”
This is a significant admission from someone aligned to the center-left Concertación (today the Nueva Mayoría) and an indictment of the entire parliamentary left political caste that has sought to lay the entire blame for the unpardonable state of social and public infrastructure solely on the military dictatorship and its free market economic policies. In reality they intensified these same policies by providing a miserly 4 percent of GDP to the health budget, creating among the worst staff-to-patient ratios in the OECD and a resource and infrastructure-starved public health system.
This is the background to the San Borja disaster under conditions where COVID-19 cases are rapidly rising in Chile, today reaching the high incidence rates of last winter in the middle of the summer period. The number of daily cases being reported has reached 4,000. As of January 28 the total number of confirmed and suspected cases reached 821,130, along with 24,429 deaths according to the Health Ministry’s latest report.
The disaster is compounded by the fact that regional hospitals are sending their critical patients to Santiago as they have no more bed spaces. This is the case for the region surrounding Valparaíso, Chile’s second largest city. Both the Carlos Van Buren hospital and the Gustavo Fricke hospital reached 100 percent occupancy, while the mining region of Antofagasta was forced to turn to the Military Hospital due to lack of personnel.
Throughout the pandemic the overriding concern of the ultra-right government of President Sebastian Piñera has been to keep profitable sectors of the economy open. His former health minister, Jaime Mañalich, who was forced to resign after caught providing false coronavirus figures to the general public, implemented a “dynamic” quarantining regime that allowed the mining and other export-oriented industries to remain open for business. This led directly to COVID-19 spreading to other regions, especially those with a mining workforce.
Where quarantining was implemented, no meaningful assistance was provided to the millions that, either due to being furloughed without pay or working in the informal sector, were forced to break curfews for food or work. This created the conditions for the virus to rapidly spread in the densely populated working-class suburbs and shanty towns of Santiago, Valparaíso and elsewhere.
The latest health minister, Enrique Paris, has intensified the government’s criminal “herd immunity” policies that directly contributed to the present second wave. Late last year, the government made the extraordinarily reckless decision to open the country to international tourism.
In this whole process, the right-wing government has been aided by the parliamentary left and the Communist Party and Frente Amplio-dominated corporatist unions which agreed to nonessential export industries remaining operational. They accepted a freeze on collective bargaining, wage cuts and the furloughing of workers for the benefit of employers, and they have point blank refused to call any industrial action against poverty, hunger, insecurity and evictions impacting the working class.
An indefinite strike called by the health unions late last year was ended as quickly as it began once a sellout deal was stitched up. One of the key demands—the payment of a paltry COVID Bonus of 200,000 pesos (US$275), reduced from the 500,000 pesos (US$650) originally pledged by the Congress earlier in June—has yet to be paid.
A study published last week by the nurses association evaluating variables—such as the number of new cases, mortality rates, the characteristics of the second wave in Europe, the government’s mismanagement and the vaccination processes—concluded that cases could quadruple by the winter period. But even under this impending cataclysmic scenario they refuse to mobilize the working class.
With this track record of criminal negligence and callous indifference on the part of the entire political elite, the working class needs to draw critical lessons and intervene with its own agenda. It must break with bourgeois politics, especially the Stalinist PCCh, the pseudo-left Frente Amplio and the establishment left who are all wedded to parliamentarism and defend capitalist private property. It must reject the domination of the corporatist unions and create new organs of political power that are comprised of and controlled by the rank and file.
Only with a revolutionary socialist perspective can the struggle of the working class make any advances. The International Committee of the Fourth International is elaborating a genuine socialist response to the pandemic. We encourage workers and youth in Chile to contact the ICFI to begin this struggle.