“They didn’t listen”

SANTIAGO, CHILE - MAY 15: A Police officer uses a thermometer to measure the temperature of a citizen at police station, before the metropolitan area of Santiago enters in a government-ordered lockdown on May 15, 2020 in Santiago, Chile. Quarantine is imposed after the number of cases grew rapidly in the last week, threatening the health system capacity. (Photo by Claudio Santana/Getty Images)

A police officer takes the temperature of a man as he enters a police station in Santiago, 15th May 2020

South America had longer to make its preparations for the coronavirus pandemic than any other region, with the first case not reported until 25th February. The headlines were dominated by Brazil, which by June had recorded the world’s second highest death toll. It was Chile, however, that led the continent in cases per capita.

Chile’s public health crisis overlapped with an era-defining social movement which had already sent the country into a tailspin. In October 2019, a week of protests against an increase in subway fares in the capital, Santiago, triggered six months of mass street demonstrations against inequality in every walk of life, including healthcare. It was only when coronavirus appeared that protesters began to reluctantly withdraw from the streets, leaving the social tensions unresolved.

With the government still reeling from the protests and failing to provide clear leadership on how to tackle coronavirus, Izkia Siches, a determined 34-year-old doctor and the president of Chile’s medical union, stepped forward. As the de facto spokesperson for the medical community, she began to play a pivotal role in holding the government to account, making early public addresses calling for full lockdowns to be imposed and highlighting statistical discrepancies in official data – all while working long hours at a hospital in central Santiago.

“Chile’s pandemic response was defined by our authorities implementing ‘dynamic’ or partial quarantines in the big cities,” explains Siches. “From our point of view, this was a big mistake.” From a position of relative anonymity, Siches suddenly found herself meeting with billionaire right-wing president Sebastián Piñera and his ministers in an effort to rally them behind a coherent, science-led plan to tackle the pandemic.

Piñera’s government ignored Siches’s repeated calls for a full lockdown to be enforced while case numbers remained low. “They didn’t listen to the medical community even though we had been sounding the alarm from early on, when it was mostly the rich neighbourhoods that had confirmed cases,” says Siches. “Now we are looking at a widespread public health disaster.”

On 19th April health minister Jaime Mañalich announced that the partial restrictions that were in place would be eased, with public sector employees who had been working from home returning to their offices in the first phase of a ‘gradual return to normality.’ A day later, the ministry announced that people could go out to meet friends for a coffee and on 30th April the first mall reopened in Santiago amid great fanfare while there were still only 16,000 cases nationwide.

The government’s premature triumphalism melted away as the virus pushed into the poorer, more crowded parts of Santiago, and case numbers escalated. Mañalich began referring ominously to the “battle for Santiago”, and the government imposed a full citywide lockdown on 13th May when there were already 46,000 confirmed cases in Chile.

Official advice stated that those in isolation should be in a room on their own with a window and avoid sharing a bathroom – a luxury beyond the reach of many households in Santiago. Unemployment rose to its highest level in 35 years and food shortages in the suburb of El Bosque saw renewed street protests.  As the government hurried out a food aid programme and modest support for the most vulnerable, Mañalich said that he had not appreciated the levels of poverty and overcrowding in parts of Santiago. The disconnect between the government and its citizens was laid bare and Siches’s frustration boiled over. “What country do they live in?” she asked, exasperated, in a TV interview.

“When this onslaught passes, I’m hopeful healthcare can take up a far more prominent place
in the national agenda”

Siches’s insistence on the government publishing transparent, accurate data had also been met with resistance. In late April, it changed its methodology for categorising and reporting coronavirus cases three times in 24 hours. “We believe the health ministry has insisted on restricting and retaining the information for themselves,” declared Siches in an address in front of the presidential palace. “We need to find a new way of governing this pandemic.” It was not until June that the administration brought its reporting of deaths in line with international standards, resulting in a rise of more than 650 in one day.

Siches’s visibility as a spokesperson has come at a cost. She has been besieged by media inquiries into her personal life and the union has had to report a number of threats made against her to the police. “That’s a symptom of Chile’s misogyny,” Siches tells me. “It speaks of the need to invalidate female leadership.” However, her impassioned defence of a scientific approach has won her many fans as well, and in early June she featured in a survey canvassing people’s picks for the country’s next president. Although she has been quick to cool speculation about a run in 2021, Siches will celebrate her 35th birthday in March next year, making her eligible to stand.

When it does eventually emerge from the pandemic, Chile will find itself at a crossroads, with an opportunity to enact major change. In October, the country will have a referendum on whether to tear up its Pinochet-era constitution and replace it by one written with citizen participation, a concession secured from the government by protesters. There is hope that a new constitution will help address areas including health, where inequality has been thrown into sharp relief by the virus. “The pandemic could morph into a great opportunity to ensure the healthcare system leaves nobody behind,” Siches tells me. “We need a public sector which is more robust, modern and dignified. When this onslaught passes and Chile can reflect, I’m hopeful healthcare can take up a far more prominent place in the national agenda.”

Posted on Thursday, September 14th, 2023 - Categories: #38 - Jan-Mar 2020, App Issues.