Letter from El Salvador — From the October 2016 issue

Innocents

Where pregnant women have more to fear than Zika

Download Pdf
Read Online
( 4 of 7 )

My first morning in San Salvador, I read a report in the newspaper about a baker’s difficulties finding a job. The man, who had years of experience, had responded to an ad that gave the bakery’s hours and phone number but omitted the most crucial piece of information: Which gang controlled the neighborhood? Was it Mara Salvatrucha, known locally as the Letters, or Barrio 18, the Numbers?

Invisible lines divide the capital. San Salvador is a hot and hazy city of concrete houses, barbed wire, shacks, and air-conditioned shopping malls sprawled out at the base of a stubby volcano. Most people use the same landmark to orient themselves: a big statue of Christ known as “El Salvador del Mundo” (“Savior of the World”), which presides over a traffic roundabout. “Above Salvador” is where the rich people live, in gated communities built up the side of the volcano. The baker lived “below Salvador,” where the Letters and Numbers divide territory. There are no checkpoints — control is complex and subtle — but even those who are not affiliated with either gang are painfully aware of which runs their neighborhood, and of the possibility that if they set foot in the wrong place they could end up killed. This is how bus commutes that should be ten minutes become forty-five-minute trips to take the long way around — just in case. The police are rumored to have a map of El Salvador with all the invisible lines clearly drawn. If it exists, they keep it to themselves. Eduardo Halfon, a Guatemalan novelist, has described the constant calculation of risk as a “normal, everyday psychotic state.”

At a hearing to reduce her sentence, in San Salvador, María Teresa Rivera holds a picture of her son, Oscar, who was six when she went to prison. She had already served four and a half years in jail for aggravated homicide of her prematurely born infant

At a hearing to reduce her sentence, in San Salvador, María Teresa Rivera holds a picture of her son, Oscar, who was six when she went to prison. She had already served four and a half years in jail for aggravated homicide of her prematurely born infant

The baker, who lived in Letters territory, was relieved to learn that the bakery was in Letters territory, too. Still, to get the job, the newspaper reported, “He had to handle two interviews: one with the owner of the establishment and another with the local head of the gang.” The gang leader asked him for his I.D., to check his home address and see to his satisfaction that the baker wasn’t a policeman or a spy from a rival gang. In the end, the baker was hired, so long as he agreed to teach two kids who help out the gang how to bake bread.

Before my arrival, El Salvador overtook Honduras as the murder capital of the world. More Salvadorans were killed in 2015 than in any year during the civil war. A young woman told me that she was “lucky” to have seen only a few bodies on the street. Femicide is now a leading cause of death for women. Sometimes, women join up with gangs for protection, or else to make money or to be part of the scene. A young woman named Medea told Juan José Martínez, a Salvadoran anthropologist who studies gangs, that women have two choices for initiation: to be beaten brutally or to have sex with all the members of the group. Medea chose the beating. She explained that, when gang girls are raped, “afterward the homeboys don’t respect them.” Martínez notes the “diabolical sarcasm” of gangs, which call rape “initiation through love.” Medea described one such initiation in which her husband participated:

They all got over her. They did everything to her, at least thirty got on her. . . . The girl called me and said she couldn’t bear it anymore, she was hurting, so I told them, “Hey, guys, enough already, leave her,” but they didn’t pay any attention. . . . They did everything to her, and when I say everything I mean everything. When I went to see her at the end she was a rag.

Murder makes headlines, but rape does not. Gang members rape one another’s girlfriends or sisters as revenge or punishment, and initiate new boys by finding a woman or girl for them to rape — perhaps together, to really feel close. Or they will rape simply because they are in control of whole city blocks and they can. The commonly cited number is that five Salvadoran women are raped per day, but those are only the reported cases. Indeed, rape is so common that, were there an abortion-law provision for victims, it is easy to imagine that a substantial proportion of pregnant women and girls would qualify.

In this atmosphere, El Salvador’s official response to Zika seemed delusional, if not insulting. In January, after the number of registered cases rose to more than 4,000, Eduardo Espinoza, the deputy minister for health policy, announced: “We are recommending to women of fertile age that they take precautions to plan their pregnancies, and avoid getting pregnant this year and next year.” Many countries have suggested that women delay pregnancy because of Zika, but until Espinoza’s announcement, no government had flatly told women not to get pregnant for a couple of years, not even during the rubella or AIDS epidemics.

An ultrasound photograph of Milagro Castro, a twenty-four-year-old woman who is almost five months pregnant, San Luis del Carmen, Chalatenango. She contracted the Zika virus in her first trimester

An ultrasound photograph of Milagro Castro, a twenty-four-year-old woman who is almost five months pregnant, San Luis del Carmen, Chalatenango. She contracted the Zika virus in her first trimester

I met Espinoza in his office downtown, a short walk from the Plaza de la Salud. All expansiveness and geniality, he stood by the government’s message, insisting that building up herd immunity is the answer. “It may seem extreme in the context of Latin America, but not for us,” he told me. Mosquito-borne chikungunya infected some 17,000 people in El Salvador in a single week in 2014. Zika appeared for the first time in November 2015, and the government feared that the virus curve could look similar. Espinoza was well aware of the nightmare scenarios, and explained that El Salvador doesn’t have the money to deal with babies born with microcephaly, who “enslave their mothers.” The health ministry’s Zika program also includes fumigations, although these have run into trouble when gang members refuse entry to certain neighborhoods. Espinoza conceded that asking women not to get pregnant for two years was a controversial move. “It was a recommendation, right? We can’t tell people not to have relations.”

Espinoza told me that he feels considerable pressure from his North American counterparts to control the spread of Zika. But even as the number of infections in the United States climbed to more than 6,400, Congress provided no funding to combat the virus domestically or abroad. In June, House Republicans proposed such a bill, but it was $800 million short of the $1.9 billion President Obama had requested, and it contained provisions limiting the distribution of contraceptives and blocking Planned Parenthood from providing services. Congress broke for summer recess before approving a relief bill of any kind. Meanwhile, the number of babies worldwide born with microcephaly as a result of the virus reached 1,500, and the New England Journal of Medicine reported a dramatic rise in the number of women seeking abortions in Zika-affected countries, including El Salvador.

Zika poses yet another possible threat to Salvadoran women, because there is some evidence that infection may increase the probability of miscarriage. Nelson Menjivar, a gynecologist in San Salvador, told me that he saw an increase in miscarriages and stillbirths after the disease arrived. The mothers were young, “the healthiest in the world,” he said, so he was puzzled. “I saw three stillbirths in the same afternoon.” The Centers for Disease Control and Prevention said there is no concrete proof that Zika can cause miscarriage, but scientists there are studying a possible link. Espinoza acknowledged that there could be difficulty in differentiating illegal activity from tragic loss. “Many abortions are miscarriages, abortions that aren’t induced,” he said. (The term for “miscarriage” in Spanish is aborto espontáneo.) “Here, that is punished. There are women in prison. We have the perception that surely many of these women are unjustly in jail.”

You are currently viewing this article as a guest. If you are a subscriber, please sign in. If you aren't, please subscribe below and get access to the entire Harper's archive for only $45.99/year. Or purchase this issue on your iOS or Android devices for $6.99.

= Subscribers only.
Sign in here.
Subscribe here.

Download Pdf
Share
is a doctoral candidate in Latin American and Caribbean history at New York University. Her most recent article for Harper’s Magazine, “Displaced in the D.R.,” appeared in the May 2015 issue.

More from Rachel Nolan:

Get access to 165 years of
Harper’s for only $45.99

United States Canada

THE CURRENT ISSUE

Feburary 2017

Blood and Soil

= Subscribers only.
Sign in here.
Subscribe here.

A Grim Fairy Tale

= Subscribers only.
Sign in here.
Subscribe here.

Trump: A Resister’s Guide

= Subscribers only.
Sign in here.
Subscribe here.

Little Things

= Subscribers only.
Sign in here.
Subscribe here.

The Patient War

= Subscribers only.
Sign in here.
Subscribe here.

Remainers

= Subscribers only.
Sign in here.
Subscribe here.

view Table Content
Close

Please enjoy this free article from Harper’s Magazine.