Covid-19 has arrived in Bolivia, one of Latin America’s poorest countries, exacerbating a deepening political crisis and structural economic fragility.
In common with many other countries in Latin America, the lack of widespread health infrastructure, low investment in healthcare as well as a population overwhelmingly dependent on the informal economy, makes Covid-19 a particular challenge for Bolivia. Moreover, there are worrying indications that the pandemic is serving as a pretext for the expansion of state-military control by the conservative government following a coup last November.
The majority of cases are in the lowland city of Santa Cruz. The first two cases were confirmed on March 10 and involved two women who had traveled to Italy. As of April 3, there are 9 dead and 132 confirmed cases of Covid-19 in Bolivia out of a total population of 11 million. This gives a mortality rate of around 6.5 percent, the highest in Latin America and well above the global average. In a press conference on 2 April, the representative of the World Health Organisation (WHO) in Bolivia, Alfonso Tenorio, attributed this high lethality to a lack of testing and said that the actual number of those infected is probably much higher.
The government response has been to shut down borders and impose a strict quarantine with working and trading hours severely limited. At a press conference on April 1, the Minister of Health Aníbal Cruz admitted that, “we do not have the health conditions to confront this global pandemic, but we can stay at home to help.” China, and the United Nations Development Program (UNDP) have contributed supplies and testing kits this week.
But the principle of the quarantine collides with a stark reality; If people do not work, they do not eat. According to the IMF, Bolivia has the world’s largest informal economy, constituting 62% of its GDP. Despite a drastic reduction in poverty under former President Evo Morales, around a third of the population live in poverty. Women make up the majority of those who work in the informal sector, and they are more likely to earn lower wages. This situation is even more pronounced for indigenous women.
To alleviate the effects of the lockdown, the government promised to distribute basic food provisions. But these have failed to materialise and have been widely criticised as insufficient. In response, large protests have recently taken place in four regions — Beni, Tarija, Santa Cruz and the city of El Alto – in defiance of the quarantine.
“The President said that they will give the family food parcels until mid-April, the population will not be able to last that long without food. We ask everyone, the Mayor’s Office, the Interior and the central Government, to take pity on the people, ” said Jhonny Tereba, leader of the civic group, the Federación de juntas Vecinales (Federation of Neighbourhood Committees – Fejuve) in the tropical city of Trinidad.
Transport workers have been especially hard hit. In the city of Cochabamba, the transport workers union, Federación del Autotransporte Libre de Cochabamba declared an emergency, saying that the quarantine had left them without any income. “We work today, we eat today; we don’t work, we don’t eat. The few resources we have are running out, the situation is more critical the next day, ” it said in a written statement, according to reports by news outlet Los Tiempos.
Many of the community leaders involved have since been arrested. Last week it was reported that over 1200 people have been arrested for disobeying the quarantine order. The fine is a hefty 1,000 Bolivianos (around £100). While funds have been slow to appear for food parcels, the Bolivian police this week has nonetheless received a pay rise of around 450 Bolivianos (around £50). The police have been a key ally of the new regime after mutinying against ex-President Morales in November last year.
In addition to the mounting economic hardship, there are doubts that the Bolivian healthcare system can withstand the strain if Covid-19 cases increase sharply, a situation not helped by the expulsion of over 700 Cuban doctors last November.
In March 2019 the Morales government won praise from the World Health Organisation (WHO) for making free healthcare available to the poorest citizens through the Unified Health System (SUS), which provides basic care to around 70% of the population. However, much healthcare is concentrated in urban centres while rural areas, where many indigenous peoples live, often lack anything more than basic healthcare provision. Accessing soap and hand sanitiser can also be expensive and an absence of income due to lockdowns makes this even harder.
To make matters worse, Covid-19 has struck at a time when Bolivia is more politically polarised than in the past fifteen years. In November, longtime President Evo Morales was forced to resign in a military-civic coup following disputed elections in October. The country is now governed by an interim president, right-wing evangelical Jeanine Áñez whose party received just 4% of the vote.
Her short regime has been marked by state massacres and ongoing political instability. In the immediate aftermath of the coup in November, at least 30 peaceful protestors were killed by police-military forces, and many supporters of Evo Morales’ party, the Movimiento al Socialismo (MAS), continue to face violent reprisals. In an extraordinary break with human rights protocol, in November the government granted the military immunity from prosecution if they use force in legitimate defence. After a backlash, the government rescinded the decree.
Worryingly, presidential elections scheduled for May this year have been postponed due to Covid-19, with no new date set.
Meanwhile a functioning press has been weakened by the shutdown imposed as a result of Covid. This week, the President of the National Press Association warned that newspapers in Bolivia were on the verge of collapse; 95% of their revenue comes from print editions which have ceased due to the quarantine. This has worrying implications for government accountability and the spread of information at a time of national crisis.
Covid-19 represents a grave risk to public health in Bolivia but its effects may well be dwarfed by an escalating political crisis.
Olivia Arigho-Stiles is a CHASE-AHRC supported PhD candidate in the Department of Sociology at the University of Essex. She returned in February from five months fieldwork in La Paz, Bolivia. Her research explores the relationship between environmental politics and highland indigenous movements in 20th century Bolivia.
Image: author’s own.