For “illegal aliens” life in the North is not all milk and honey. Even for those who make it without being caught and deported, things often do not turn out as hoped, either in economic or human terms. Living in constant fear of being caught and deported can be traumatic and humiliating. In order to secure and keep a job in such a vulnerable status the migrant must learn to swallow his pride and suppress his feelings when subjected to racial prejudice, unfair treatment, humiliation, and deplorable working conditions. Frequently this leads the migrant to embitterment, misdirected anger, and heavy drinking. He often tends to develop a more hostile or aggressive personality.

Despite good intentions, many men who migrate north never send back money to their wives and families. Others never return. Some remarry, sometimes to a US citizen in order to become a legal resident.

A common pattern for the men separated from their wives through migration is to have a sequence of affairs with prostitutes or other women (or men). The health consequences can be far-reaching and sometimes deadly.

Wives and families who stay home. We have spoken of the hardships of women who migrate North. But also many of the wives left behind are subjected to cruelty and sexual exploitation. When a husband is absent, his wife and children typically stay with his parents. The lone woman is considered fair game for neighbors and relatives. Sometimes her courtiers make an effort to seduce her. Sometimes they simply violate her. Then they often use her "infidelity" as a bribe for further favors or to extort from her money sent by her husband. If she gets pregnant—and even if not—the “soiled woman” tends to become a social outcast, ridiculed and shamed in the community. And if her husband returns, her infidelity—real or suspected—is even more severely paid for.

In districts of high migration, the incidence of violence to women has escalated into a major health problem. Even the children of women left behind are subject to sexual exploitation. Premature pregnancy in such children in one community (Gualaceo) reached 28%.

HIV/AIDS. A consequence of the high rate of migration, whereby men separated from their wives tend to "play around" with other women, has been the growing spread of HIV and AIDS. In one presentation at the Forum, two doctors told the heart-rending story of a mother whose husband had migrated to the US. He sent back no money, and his wife struggled to keep her 3 children fed and healthy. When at last her husband returned he brought no money. Although he had been gentle to her before, now he was cruel and arrogant with her and took no interest in the children. In time the couple divorced. But even then, when drunk, the ex-husband would come and force the woman to have sex.

In time the woman’s health began to fail. She had splitting headaches, and sought help at the University Hospital in Cuenca. Doctors performed tests, suspecting everything from depression to tubercular meningitis. Eventually they diagnosed an opportune fungal infection (Cryptocytosis). A test for AIDS proved positive. As the poor woman approached death, her biggest concern was for her children. She worried they might suffer and die, not from AIDS, but from abandonment and hunger.

BLACK GOLD! — Damage to environment and health caused by oil companies drilling in the Amazonian rain forests

At the Cuenca Forum a report was given by Dr. Jose Pozo on "Oil and Health in Amazonia.” The Quechua Indian term for crude oil is Yana Curi, or Black Gold. For 20 years tribal peoples in the Amazonian rain forests of eastern Ecuador have been protesting the damage to their habitat and their health caused by the environmentally reckless extraction of oil by Texaco and other transnational oil companies. In spite of protests by the Indians together with environmental and human rights groups in Ecuador and beyond, the oil companies have done very little to make amends. In 1991 the book "Crudo Amazónico" by Judith Kimerling documented the extent of the harm. In 1993, 30,000 tribal people sued Texaco for irreparable environmental damage. They have subsequently brought claims for health damages, with demands that Texaco clean up the contamination it has caused.

But to date the courts have not sustained the charges. Texaco, backed by the Ecuadorean government, has said there is insufficient evidence that contamination by crude oil has harmed people's health.

For this reason, in 1997 the Frente de Defensa de la Amazonía and a team of local health workers conducted an epidemiological study—in collaboration with the London School of Hygiene and Tropical Medicine. The study, which covered 9 oil contaminated communities and 14 non-contaminated communities, produced strong evidence of ill health caused by crude oil:

Study Results: Contamination by Crude Oil

-- River water (used for drinking) in the contaminated area had levels of toxic hydrocarbons up to 100 times the legal limit in European countries.

-- People in contaminated villages had more skin infections, nose, throat and eye irritations, earaches, headaches, diarrhea and gastritis than those in non-contaminated villages.

-- Risk of miscarriage was 2.5 times higher in the contaminated communities.

-- Risk of cancer was 2.3 times higher in contaminated as in non-contaminated villages. Increased risk of stomach, larynx, and liver cancer was especially evident in men.

From this study, the Amazonian Defense Front concludes that "To avoid the occurrence of situations like this and to assure that development projects promote health rather than harm it:

-- the government should legislate new environmental standards and institutions with power to control the petroleum industry, to eliminate hazards to health or environment, and hold the industry responsible for any harm they might cause.

-- studies are needed that consider the impact on health (not just environment) and that integrate measurements of environmental risk and health, with adequate community participation.”

However, getting the Ecuadorean government to tighten regulations on the oil industry will be an uphill battle. Oil export is the government's main source of funds to service its huge foreign debt. To boost such payments, the World Bank is now pressuring Ecuador to raise the price of gas by 40%. This will push up prices of other basics, increase inflation, and make it even harder for poor Ecuadoreans to feed their children.

Conclusion: Forging a Fairer World

The presentations at the Cuenca Forum provided testimony by diverse persons and communities who have suffered everything from hunger to sexual assault to AIDS, as result of a widening income gap and deepening poverty. These inequities are aggravated by global decision makers and transnational corporations that put profit before people.

The Forum concluded that there is urgent need for a united effort--both within Ecuador and among concerned people and groups around the world--to protest the current unhealthy and inequitable policies of the global market economy. Together we must forge an alternative model of economic and social development that promotes equitable and sustainable Health for All.

The forging of a plan of action to achieve a healthier, fairer, more democratic, ecologically balanced society will be the goal of the People's Health Assembly in Bangladesh (see page 7). To this end, the Regional Forum in Cuenca was a groundbreaking preparatory event.

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