HEALTH : Proud Argentina Reconsiders as Cholera Spreads

A virulent outbreak of cholera has shocked Argentines who proudly assumed that their country was resistant to such afflictions of underdevelopment.

Despite economic setbacks in recent years, Argentina stands out in Latin America as a nation with an image of middle-class well-being. Bad things like cholera don’t happen to countries like this, many Argentines thought.

But since January, cholera has spread rapidly in northwestern Argentina and threatens to infect other parts of the country, including Buenos Aires. Argentina has had more than 1,000 cases so far in 1993, with a death toll of 20.

“Cholera fundamentally is a sickness that is a byproduct of underdevelopment,” said Health Minister Julio Cesar Araoz. “In the federal capital, people don’t want to see that there are whole sectors of the society where there really is poverty and indigence.”

President Carlos Saul Menem recently disputed Araoz’s contention that cholera is a manifestation of poverty. Menem argued that the outbreak is due to “the carelessness of a lot of people who do not follow health authorities’ advice.”

Some political analysts speculate that Araoz’s job is in jeopardy because of the public disagreement, but the minister said in an interview that he and Menem agree on anti-cholera strategy.

Starting with an epidemic two years ago in impoverished Peru, cholera has spread to most countries of Latin America and is now considered endemic in the region. Cholera came to Argentina early last year from neighboring Bolivia, South America’s poorest country.

Bolivia had 21,567 confirmed cases of cholera in 1992 and 3,210 deaths. Argentina registered 553 cases of the disease and 15 deaths last year, but health authorities controlled the outbreak, and no cases were reported in the last seven months of the year. In January, however, cholera returned and spread more rapidly than before. Most of the cases so far have been in Salta and Jujuy provinces, which border Bolivia and are among the poorest areas of Argentina.

Bolivian farm workers and other Bolivians with relatives in Argentina come and go across the border. Because many of them are cholera carriers, Araoz’s ministry has established special health controls at the border.

The Labor Ministry has begun inspecting conditions on farms in the northwest and levying fines for health violations. “Cholera in the northwest is greatly spread by the appalling working conditions of rural labor, and this is the fault of Argentine employers, not their Bolivian workers,” said the Buenos Aires Herald, an English-language newspaper.

Traditionally, border crossings in the northwest increase during the pre-Lenten carnival season, when people gather for public fiestas of feasting and dancing. On Araoz’s recommendation, the Argentine government has canceled the carnival festivities this month because of the danger that cholera will spread through food, drink and crowd contact.

Although cholera has not yet spread to Buenos Aires, Araoz said large parts of the metropolitan area could be susceptible to an outbreak because they have no sewer or water lines. “We are prepared to jump on the outbreak,” he said.

Meanwhile, the government has announced a $1.8-billion social plan aimed at improving conditions for the poorest Argentines. Cholera undoubtedly has given impetus to the program.

“I have a negative situation with cholera, but I have a positive situation when it awakens political consciousness of what must be done in the future for people’s health,” Araoz said.

A Spreading Plague

To the shock and chagrin of Argentinians, cholera--a disease linked with poverty and poor sanitation--has become a bane of the largely middle-class nation. The disease has swept southward from Peru, through Bolivia to the northern Argentine provinces of Salta and Jujuy.

Peru: 286,850 cases, 707 deaths in 1992

Bolivia: 21,567 cases, 3,210 deaths in 1992

Argentina: 553 cases, 15 deaths in 1992; 1,000 cases, 20 deaths, thus far, in 1993