This week, the 26th Cochrane Colloquium was going to begin in Santiago, Chile. This annual meeting brings together over 1000 delegates from all over the world. However, in an unprecedented decision, the organizing committee canceled the event, which was informed on Sunday morning:
“Due to the worsening situation of civil unrest across the city of Santiago, the decision has been taken to cancel this year’s Cochrane Colloquium.”
What led to this decision? What happened in Chile, from one day to the next, that triggered a social outburst never seen in this country since the return to democracy in 1990?
In Santiago on Monday last week, high-school students initiated a protest against the fare hikes of the subway system, by jumping in hoards over the access turnstile. They repeated the protest on Tuesday and Wednesday. By Thursday, more people were joining the mass fare evasion, not only students. Friday, the city was slowed down by out-of-the-ordinary traffic jams, and, by night, the civil unrest began with barricades, pot-banging, and horn-honking that spread throughout the city like fire on dry grass. In less than two days, the main cities of Chile had joined in the spontaneous and self-convened protests. On Sunday, the president, Sebastián Piñera, called on the military and applied State of Emergency with curfew in Santiago, which the military later imposed on most cities of Chile.
Meanwhile, the Cochrane delegates were flying in unknowing what they would face upon their arrival. With public transportation paralyzed, mass demonstrations taking place day after day in different parts of the capital and rapidly expanding through the country, it was impossible to sustain the Colloquium, and the organizers canceled, stating the following:
“The situation in the city centre has deteriorated in the last 24 hours and remains volatile and uncertain: a curfew is in place, there is extremely limited public transportation and there are reports of a two-day national strike beginning on Monday. The safety and security of all Colloquium delegates is our highest priority. For this reason, we believe cancelling this year’s annual event is the most appropriate decision.”
The reasons for this social outburst are not to be found in the modest fare hike of mass transportation, but in growing civil unrest that has been incubating for decades due in large part to the non-resolved inheritance from the civil-military dictatorship of Pinochet (1973-1990). In the 80s, and following the lines of the Washington consensus, Chile implemented extreme neoliberal policies that led to the privatization of practically all natural resources; of the worker’s pension system (not the military, though); of a profound marketization of health care, education, and basic services, including public transportation. Together with these economic policies, the Pinochet regime designed a political constitution that rendered impossible any substantive legal or constitutional change. Furthermore, a non-proportional electoral system was set up that over-represented the political right in the national congress, which lasted for at least 25 years (not to mention the designated senators, most of which drawn from the armed forces, including Pinochet himself, a contraption that was revoked only after 2005).
The economic model, characterized by extreme marketization and privatization—including water rights—together with a political system bonded by the constitutional legacy, resulted in a country with one of the highest gross domestic products of Latin America (according to the International Monetary Fund), coupled with one of the highest indicators of inequality in the region, over Bolivia, Argentina, Peru and Uruguay (according to the GINI indicator of the World Bank). An extreme concentration of wealth, plus a political system incapable of changing and responding to the calls for greater democracy and social inclusion, led to the current institutional crisis. For sure, many attempts for reform were made—some successful, some not. But none that actually would redistribute power and privilege from a concentrated few to the dispossessed majority. None that could shift the balance of the social contract based on the exploitation of the workers in favor of capital, as exemplified by a 45-hour working week and a salary median of USD 550, according to figures from the Chilean National Statistics Institute (2019).
The demands now flourishing in The Rebellion of Santiago, as some have called this social outburst, refer to ending the private pension fund system that does not benefit workers who are beginning to retire now, but instead, accrues enormous financial benefit for companies that are traded in the stock market. They also include demands for access to health and to all of the social rights that have been restricted and violated for way too long. These are all demands for social justice, for inclusion without discrimination. They are also a demand for political and economic change. Essentially, people are demanding an end to the abuse that they are constantly subjected to and to a system of privilege based on birth, not merit.
In this process, from one day to the next, everything precipitated for our friends of the Cochrane Collaboration. They did not see it coming. We did not see it coming. To all of us, including our president, the rage exploded in our faces. Very regrettably, the response from our government has been to militarize the solution, which has led to violations of human rights and avoidable deaths (and counting as I write these lines). Each day brings a new mobilization—the next two will be a national strike. Nobody knows how this process will end. What we do know is that we are all part of the quest for the solution on how to make our motherland, Chile, a place that holds us all in dignity and brotherhood.
Santiago, October 22, 2019
Citation: Bachelet VC. The social outburst of Chile and the cancellation of the 26th Cochrane Colloquium. Medwave 2019;19(9):e7707 doi: 10.5867/medwave.2019.09.7707
Publication date: 23/10/2019
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