In this interview, Chilean union leader and a member of the World Women’s Committee (WOC) of Public Services International (PSI), talks about the exhaustion of primary health professionals in Chile as they fight the pandemic, the actions of the country’s trade union and social organizations in the face of the current socioeconomic crisis, and the need for a new Constitution that could potentially represent the emancipation of women, a respect for plurinationality, and the end of the neoliberal model that has been embedded in Chilean society for decades. On May 15 and 16, Chileans will elect the members of a Constituent Assembly that will be in charge of drafting a new Constitution.
Espinoza is also vicepresident of PSI’s Regional Inter-America Women’s Committee, and a leader in the National Confederation of Municipal Health Workers (CONFUSAM) and a spokesperson for Unidad Social platform and for a national group dedicated to fighting for pension rights called NO + AFP.
We are talking while primary health workers in Chile are demonstrating in the streets. Could you start by explaining the reasons for the protests?
It is a very desperate reaction. Obviously, from an ethical perspective we feel that we cannot stop working, that we cannot go on strike, but in our recent national assembly, we clearly saw the extent of the problems we are facing… between 25% and 30% of workers are on medical leave. Due to stress, due to health problems associated with the exhaustion that we have in health services. We have always worked with a structural deficit. Unfortunately, we are accustomed to working without enough resources, which is a structural problem inherited from the time of the Pinochet dictatorship which dismantled the National Health Service and installed the ISAPRE [Institutions of Social Security Health], the health companies. Health workers are very committed, and we also have this heritage of the National Health Service that puts us in a good position because we have a public health network with complete national coverage. And we also have a strong health culture in the staff and in the population. The population follows instructions and orientations, so that is a tremendous help that allows us to carry out our work, but in this pandemic, we continue to have the problem of chronic shortages. Staff have not been replaced, we are doing the same work as always, and have added the activities necessary to respond to the pandemic. For example, we have very efficiently advanced in the vaccination of the population, but that is principally due to what remains of the National Health Service and to the commitment of health workers.
But we are literally collapsing because in addition to the chronic structural problems, current government policies are erratic. The government communicates one thing, then goes back and does something different. For example, the strategy of testing, tracing and isolation, which is the community health approach that we have been demanding since day one of the pandemic: the government has given responsibility for these policies to the primary care sector, then to the SEREMI [Regional Secretariats of the Ministry of Health], which is another centralized entity that has very little territorial capacity to serve. Likewise, it has focused on ICU beds and ventilators, making such a show of that, without making resources available for primary health care in the community.
What do I mean? I mean there is a structural problem of low funding, but that this problem is made worse by a Ministry that has had a criminal conduct in all of its policies. All this happens because there is a lack of knowledge of the public sector - because those who are in the government are businessmen, they know the private clinics, the ISAPRE, and they do not know the public sector that serves 80% of the population - and also because the economy has been prioritized, to keep businesses open so that companies do not lose profits. The focus has not been on life, on people’s health, and the truth is that today we health workers are collapsing as a consequence. We are ready to explode, and so we are beginning to mobilize and take actions, which are not strikes, that have sought to publicize this situation and ask for help so that the resources are delivered to us, to take concrete steps to solve this, because we really feel that we are going to collapse. We will end up collapsing if this continues and if we collapse, the entire population will suffer.
The slogan of the mobilization is precisely: “If we collapse, Chile collapses”.
If we collapse, there will be no one to attend to 80% of Chileans, the population attended by the public system,
This slogan comes very much from the soul because we feel that we have been very disciplined, trying to collaborate, but we are reaching a point where we can no longer continue. The truth is that conditions since the first wave in early 2020 have changed. We are now facing the second wave with at least 25% less staff, and without resources. So, if we collapse, we will not be able to provide care to the population at a time when even though we have managed to vaccinate the population very successfully and efficiently, today we are seeing deaths of young people, we have 95% or 100% occupancy of ICU beds in hospitals. So, it is a desperate call to the State to hand over the resources and when we are calling for it to do so, we are also making clear that it is urgent that the State provide an emergency salary to the population. Because quarantines cannot be implemented by families who have to decide whether to be protected against the coronavirus or feed themselves, because they live day to day. Quarantine is not the reality in the poor neighborhoods, where living conditions are very overcrowded, and people have little capacity to protect themselves, to obtain masks. This is because the government has not implemented social and economic assistance policies for these families. It has really been an emergency income that has reached very few people and we have had to use funds from unemployment insurance and from pension savings accounts as a rescue measure, because there has not been a policy, despite the fact that our country has very good macroeconomic conditions, we have these sovereign funds that are intended to help the population in catastrophic situations, but the government has not wanted to implement a universal, decent emergency income so that the population can quarantine.
So, these are the two main demands of our mobilization: If we collapse, there will be no one to attend to 80% of Chileans, the population attended by the public system, because we are collapsing, we are making mistakes, because we are overwhelmed; and leaving the population to try to feed itself without any real quarantine, a policy that could contain the contamination rates, is leading to overwhelming our health services.
Chile is going through a crucial moment in its history. Of course, all countries are, due to the pandemic, but Chile also has had ongoing social mobilizations since November 2019 and is going through a constitutional revision process. How is the trade union movement in general, and PSI’s affiliates specifically, mobilizing so that these events actually lead to transformations that put an end to the neoliberal model?
We must start by saying that this pandemic has actually helped the government and the dominant sector that this government represents, which is a few families that own everything in the country. And President Sebastián Piñera himself is part of one of these families, with the fourth largest fortune in the country. So, it is very particular and very terrifying, what has happened to us, because the government has repressed all free expression using the excuse of the pandemic. There is a curfew and the continuous presence of the military and police since day one of the pandemic. There is persecution of the union leadership, there is surveillance, and in recent days Piñera had the nerve to threaten the television channels that have had a couple of journalists who have dared to say what we all know. And then the President of the Republic puts pressure on the editorial line of the television channel, a television channel that is actually highly useful to and forms part of the system, we are not talking about anything revolutionary.
It is as if we had returned to the dictatorship, a little more disguised, it is true, but the same measures of repression are being used, with an absolute invisibility of the activities that social organizations continue to do, including of course the unions, because we began to rise up, to launch a campaign that we call “only the people help the people”. We have developed solidary kitchens, production of masks and protective shields, we have been reconverting all this social fabric that has been strengthened by the popular revolt to take care of ourselves, to help each other. That even happens by appropriating the social networks, surpassing the use of the mass media to serve power. Today we are on this path of developing assemblies and political and social work from social networks to take care of each other.
This pandemic has actually helped the government and the dominant sector that this government represents, which is a few families that own everything in the country.
We are also fighting for the freedom of the hundreds of political prisoners of the revolt. Young people, fundamentally, who were arrested and who have been detained for months, some of them more than a year, accused of serious crimes. There is a campaign to join resources, mobilize lawyers and to raise awareness to fight for their freedom. Because they keep raiding us: the headquarters of the autonomous human rights commission in Chile, three, four times they have gone in and stolen computers. A month ago, there were systematic raids in the populations of different cities across the country in search of people who had allegedly criminal participation in the popular revolt. This is a tremendous intimidation that it is reliving the times of dictatorship. That is happening today, and it is not shown in the media, it does not appear on television. So, it has been very brutal how this pandemic has come to allow this government to silence and prevent the continuation of this mobilization. We have stated that we are in a moment where we have to be careful, we have said that we must take care of ourselves to return and win because effectively the government has not implemented effective policies to protect the population, and, therefore, many strategies have been developed to take care of each other and to prevent this pandemic from becoming more lethal, but that has also meant a lot of exhaustion and a lot of despair, because many have said: “Chile slept for 30 years and then woke up in a pandemic”.
We thinking about how this will end at some point and we can return with all the forces that are needed, because the Constituent Assembly process is happening in the institutional framework. When we decided to become part of this, we were always aware that it was important to continue jumping the subway turnstiles and push the limits in order to have a real Constituent Assembly process. And the fact of not being able to mobilize, of not being able to meet, represents a greater risk that this institutional process of the Constituent Assembly will not achieve the structural transformations that we need for a better Chile.
We from PSI in Chile and Social Unity have always said that the fight must be in all fields. In the institutional field, in the Constituent Assembly, but also in the streets, now in the streets during a pandemic, through our networks, let’s say, holding talks, making popular constituent assemblies, thematic assemblies, to also give content to this new Constitution. In this way we have continued to be active and work on this structural change that we demand.
As a member of both the PSI Women’s World Committee and the Women’s Regional Committee of Inter-America, you have been actively participating in the debates on the crisis of care and also on ILO Convention 190 on Violence and Harassment in the World of Work. Chile is going to have a Constituent Assembly with gender parity. Do you think it is possible to insert these issues in the drafting of a new Constitution?
We are really committed to making that happen. From the PSI Women’s Committee in Chile we have done a tremendous job, and we feel that it has already paid off because this is well established in the discussion of feminist groups, which for us is strategic. The fact that we have a Constituent Assembly with gender parity is a tremendous achievement, but we must be very clear: it is not because we have 50 percent women that we are actually going to have a feminist and transformative perspective. Not necessarily, right? Now, we are on this path. We have to change the dominant culture, take out this neoliberal chip that has been put into our heads, because this model is not only about structural issues, it also gets in the way of connecting to others, it’s about individualism and competition, therefore, we are in the process of getting rid of neoliberalism, and also getting rid of the machismo that all of us that have grown up in this abusive, extractivist, exploitative society have to deal with. In this dynamic, we understand that moving towards a society with a national, universal system of public care is strategic. When we say “we are going to the feminist and plurinational assembly”, they are two very strong elements, which are consensual, that in general all the groups and the entire progressive community in the country that wants change have taken up.
We are in the process of getting rid of neoliberalism, and also getting rid of the machismo that all of us that have grown up in this abusive, extractivist, exploitative society have to deal with.
We from PSI consider that two strategies are very crucial. One is tax justice, on which we must give a lot of emphasis, because it is very simple: if we do not have tax justice, we will not be able to implement all social rights, health, education, pensions. The other strategy is to raise awareness regarding the construction of a national system of care, a State that recognizes the human right to care, because when we talk about having a feminist Constitution, what does it means in concrete terms? In non-sexist language? Yes, well, but how do we effectively have a different society? It is on the basis of achieving awareness that the only way in which women can go out into the public world on equal terms is by ending this sexual division of labour and/or this responsibility for families and for the care that we require as a society. One way to make the possibility of a feminist Constitution in Chile real is through raising awareness, recognizing, and rewarding care efforts so that women have equal conditions in society.
We as PSI are very committed to the work of taking these two positions into the constituent assembly process. So, we have been working on presenting our manifesto as public service unions in Chile, to deliver it to the candidates for the constituent assembly, so that they also get on board, we are talking about it and asking about it in the debates we do on social networks, as well as in these popular constituent assembly processes that we are developing in the territories and also in the thematic areas. Health, housing, feminism, environment, we are promoting these issues that are cross-cutting issues and very themes necessary for the new Chile that we dream of.