Labor is probably strongest in El Salvador in representing health care workers who are part of the Social Security Institute. The name “social security” is misleading to North Americans. El Salvador doesn’t have a national old-age pension or disability scheme. Instead, social security refers to the national health care system. And “national health care system” is misleading to North Americans, because the system doesn’t cover all Salvadorans, but rather, only those who live in larger cities who are formally employed by a company that actually pays the social security tax, which adds up to only thirty percent of the population.
The term “union representation” is also misleading for North Americans, since in El Salvador, a union can only officially negotiate on behalf of workers if they can claim membership of a whopping 51% of workers. The Union of Hospital Workers of the Social Security Institute, or STISS in Spanish, represents about 35% of health care workers. But while STISS will probably never reach the high official watermark, they’ve been successful nonetheless in negotiating contracts with the government with a dual strategy of legal maneuvering and street tactics.
Unions in the United States have suffered violent oppression at many points in their history, but nothing like unions in El Salvador. Union organizers were prime targets of death squads during the civil war. In those twelve years, 94 union organizers were assassinated and nine disappeared. In 1999, long after the peace accords had been signed, the government began the process that continues today of privatizing health care, and relations with the union began to resemble the war years. Hundreds of workers were laid off as hospital security, food and janitorial services were outsourced to private companies. The union retaliated with a strike, which ended up to be a series of slow-downs and walk-outs that went on for almost four years. STISS was immediately joined by the doctor’s union and thousands of nurses. Their participation in a series of marches and sit-ins led to them being dubbed “The White Marches,” named for the sea of white uniforms. President Francisco Flores fired back by taking over hospitals and clinics with soldiers and firing more workers. Leaders found that their phone lines were tapped at work and at home. Masked gunmen invaded the homes of some union leaders, and fired at others in drive-by shootings. Confrontations that ended with teargas and armed violence filled the television news. At one point, strikers took over the cathedral in San Salvador.
At the same time this very public struggle was being played out, the union appealed to the supreme court and legislature of El Salvador, and the International Labor Organization in Geneva, Switzerland, asking them to intervene in the conflict. The union won several victories, but the government consistently refused to accept the verdicts. Finally, in April of 2003, the Legislative Assembly granted a blanket pardon to all strikers, decreeing that the fired workers be rehired with back pay, and the long cycle of strikes and violence ended with a tentative ceasefire.
The struggle between the union and the government isn’t over. Not every worker has been rehired. The Social Security Institute is now paying private doctors outside the system to see patients, a step towards privatization. Younger workers, who don’t remember the war years, or perhaps not even the years of the White Marches, are not as interested in the union as workers of their parents’ generation. They’ve been raised on television, and they’re influenced by the government’s vision of privatization of society, which dominates the airwaves. Even though the total number of workers in El Salvador is rising, union membership is down. But STISS considers itself to be strong, and it’s prepared to fight. On the wall outside of their offices, visitors are greeted by a portrait of Monsignor Romero, with the words “La Lucha Segue,” “The Struggle Continues.”
