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Dialectics of Terror and Healing In this book I recount a series of underreported struggles over health rights in El Salvador that date to the beginnings of the civil war in the 1980s. I examine the potential for a nondualistic theory of the body politic, or what Bryan Turner (1992) has called “a biopolitics of the somatic society.” Used in this way, body politic refers to the implicit moral ecology and sense of social contract that gives meaning to representative governance and political legitimacy in nation-states. While much of my narrative focuses on a rural health movement that arose during the twelve-year civil war and its interactions with the post-cease-fire state, in a remarkable shift after 2000 the political agenda of health rights erupted onto the national stage in El Salvador, with massive street mobilizations to stop neoliberal reforms that have impacted national politics and resulted in one of the few cases in which the World Bank backed down from a privatization agenda. With the revival of health reform as an issue in American politics and the new emergence of the international People’s Health Movement, health rights are becoming a centerpiece of global activism; this book aspires to inform those struggles. My account traces a historical trajectory in which health and healing served as key sites of engagement during two decades of struggle over the nature of the Salvadoran body politic. I first visited El Salvador in 1985 as part of a small medical task force assessing damages sustained during a military invasion of the University of El Salvador’s medical and allied health schools. I returned to document impacts on public health from the 1986 earthquake, and then moved to San Salvador in 1987 to report on the region for U.S. newspapers. My articles in American Medical News and the Philadelphia Inquirer on the military’s attacks on rural clinics led to regular work as a stringer for the New York Times San Salvador bureau during 1989. After receiving death threats in a chaotic period of urban warfare in November of that year, I moved back to the United States and entered 1 bbbbbbbbbbbbbbbbbbbbbbb Introduction Theorizing the Body and the State graduate school. I returned to El Salvador after the 1992 cease-fire to do ethnographic fieldwork on an NGO-supported community-based health system that had become established in the former war zone of Chalatenango. Between June 1992 and December 1995, I carried out eleven months of research on this “alternative” health system that evolved independently both of the country’s poorly managed Ministry of Health and of large international development institutions. In 1995 my fieldwork expanded to cover controversies over multilateral development loans for health system reforms. In 2000 I began research on the 1999–2000 health strikes with research assistance from Susan Greenblatt, a health educator living in San Salvador. I continued research on the movement that culminated in the White Marches against privatization during visits to El Salvador in 2002 and 2007. The first five chapters of this book tell a story of health work in a period of violent conflict. While thinking about health in the context of war, I have found the idioms of terror and healing helpful in two senses: as potent metaphors for the hopes and fears that buffet the human spirit under conditions of poverty and political repression, and as material anchors that ground the dialectics of struggle in existential realities of exhausted and wounded bodies—which are, after all, the substrates of poverty and war. In the process of seeing through the window of healing in an era of bloodletting, we gain insights into the symbolism built into cultural discourses about the body. The urgency of life in wartime contrasts sharply with the trivial and vapid pursuits that increasingly dominate our lives in peacetime. A well-established trove of folk wisdom deals with life close to the edge. In his book War Is a Force that Gives Us Meaning, U.S. foreign war correspondent Chris Hedges asserts that despite the carnage and destruction of war, we remain addicted to it. “War is an enticing elixir. It gives us resolve, a cause. It allows us to be noble” (2002, 3). Because of its closeness to issues of life and death, Lewis Hyde observed, medical work is also “strangely vitalizing. Death in particular focuses life, and deepens it. In the face of death we can discriminate between the important and the trivial” (1983, 206...

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