Politicians are gulping at the news that President Reagan will dispatch a 25-member military medical team to El Salvador. They see the risk of creeping expansion of the U.S. involvement but dare not complain because, at last, he has expressed humanitarian concerns.
But two voices from the medical community have been raised to suggest that help for the Salvadoran military is no cure for what really ails El Salvador.
Dr. Alfred Gellhorn, 70, the visiting professor at Harvard Medical School who led a private group on an inspection tour of El Salvador in January, told the Baltimore Sun that the crisis in El Salvador's health is caused by the government, which he called "the major offender in undermining the nation's health care delivery system."
The doctor was incensed that his report of the mission in the New England Journal of Medicine was cited by administration spokesmen to justify sending the team.
His colleague, Dr. Robert Lawrence, a professor at the Harvard Medical School, chimed in.
"I think it's outrageous to take that statement and turn it into a reason for sending military medical personnel," Lawrence said. "Regardless of the appropriateness of a humanitarian gesture, to say that it is an appropriate response to what we found is a complete distortion."
The two doctors spent considerable time in El Salvador trying to trace "disappeareds" among El Salvador's medical community, which is brutally treated by the government if suspected of treating the "wrong side."
After they left, the doctor who escorted them through the capital's maternity hospital, Dr. Roberto Rivera Martelli, was arrested. He is still imprisoned.
His offense seems to have been his activity on behalf of a reopening of the national medical school, which was closed in 1980 during the time of raids on hospitals in which government troops dragged "subversive" doctors and patients from operating rooms and beds.
The misery in the countryside is greatly aggravated by the unavailability of medical graduates, who used to give a year of national service by working in rural areas.
It is not clear whether the U.S. medics will minister to the poor. At White House briefings they were both represented as staying in the military hospital in San Salvador and as being allowed to carry weapons if "they are out in the field."
In an April letter to Dr. Robert Morgan, executive director of the National Council for International Health, Kenneth Dam, then acting secretary of state, suggested the possibility of reopening the medical school to relieve the doctor shortage.
But at a curious, day-long meeting on May 16 that brought together representatives of some 20 private voluntary agencies and the Agency for International Development, Dr. Gerald Raiche of the Department of Health and Human Services, who is just home from a tour of El Salvador, where he investigated surgical needs, said that there are "plenty" of doctors in El Salvador; they are simply maldistributed.
Otto Reich of the AID's Latin American division told the gathering that the reopening of the university medical school is "controversial" because of accusations that it had been a center for political activity.
The meeting was, by many accounts--several from sources who do not wish to be identified--"odd." It was called by Morgan, whose organization has "cooperative agreements" with the AID, at the behest of Reich and with the stated purpose of finding out "if there is an appropriate role for the U.S. private sector health agencies in El Salvador."
They were told, in effect, that there is nothing specific for them to do right now.
They were "confused and dismayed," according to Morgan, who was told by AID officials that the "security situation has grown much worse" since the summons was sent out for the meeting.
The voluntary contingent--the Catholic Relief Service, the American Friends Service Committee, the American Asssociation for the Advancement of Science and other relief and human rights groups--got no hint of the plans for the military medics, although the White House was then consulting key members of Congress. It heard instead about AID's $9 million plan to "revitalize the health system of El Salvador and repair its infrastructure."
Some members of the private sector felt that there was insufficient emphasis on the plight of El Salvador's 250,000 refugees, who huddle in camps and are dependent on care from religious groups. Many camp inmates are afraid of going outside for medical help for fear of being picked up by security squads.
Lawrence told the AID people, who rejoined the meeting after the voluntary organizations had an interval to digest what they had heard, that the prescription for El Salvador's illness is to "end the reign of terror" in the country. He says there was no comment from the bureaucrats.